Provider Demographics
NPI:1023096724
Name:WOMENS OB GYN PC
Entity type:Organization
Organization Name:WOMENS OB GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-792-3100
Mailing Address - Street 1:5400 MACKINAW RD
Mailing Address - Street 2:SUITE 6100
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9515
Mailing Address - Country:US
Mailing Address - Phone:989-792-3100
Mailing Address - Fax:989-792-9860
Practice Address - Street 1:5400 MACKINAW RD
Practice Address - Street 2:SUITE 6100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9515
Practice Address - Country:US
Practice Address - Phone:989-792-3100
Practice Address - Fax:989-792-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1W27300721OtherHEALTH PLUS GROUP ID #
MI0G360410OtherBCBS GROUP ID NUMBER
MIG00875OtherBLUE CARE NETWORK ID #
MI0G36041Medicare ID - Type UnspecifiedMEDICARE GROUP ID NUMBER