Provider Demographics
NPI:1003988460
Name:OB/GYN ASSOCIATES OF HOLLAND, PC
Entity type:Organization
Organization Name:OB/GYN ASSOCIATES OF HOLLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DAUCHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-795-4440
Mailing Address - Street 1:664 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4944
Mailing Address - Country:US
Mailing Address - Phone:616-392-5973
Mailing Address - Fax:616-392-1646
Practice Address - Street 1:664 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4944
Practice Address - Country:US
Practice Address - Phone:616-392-5973
Practice Address - Fax:616-392-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4826591Medicaid
MI2929007Medicaid
MI4092726Medicaid
MI3144434Medicaid
MI2715083Medicaid
MI4506752Medicaid
MI3144434Medicaid
MI2929007Medicaid
MIF99424Medicare UPIN
MIB47594Medicare UPIN
MI4506752Medicaid
MI4092726Medicaid