Provider Demographics
NPI:1184055394
Name:ST. CLAIR OBSTETRICS & GYNECOLOGY, PLLC
Entity type:Organization
Organization Name:ST. CLAIR OBSTETRICS & GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-329-3333
Mailing Address - Street 1:4154 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EAST CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054
Mailing Address - Country:US
Mailing Address - Phone:810-329-3333
Mailing Address - Fax:810-329-1199
Practice Address - Street 1:4154 S RIVER RD
Practice Address - Street 2:
Practice Address - City:EAST CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054
Practice Address - Country:US
Practice Address - Phone:810-329-3333
Practice Address - Fax:810-329-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty