Provider Demographics
NPI:1205012556
Name:ASPA OB/GYN, PLLC
Entity type:Organization
Organization Name:ASPA OB/GYN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-777-2550
Mailing Address - Street 1:22050 GREATER MACK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2388
Mailing Address - Country:US
Mailing Address - Phone:586-777-2550
Mailing Address - Fax:586-777-2447
Practice Address - Street 1:22050 GREATER MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2388
Practice Address - Country:US
Practice Address - Phone:586-777-2550
Practice Address - Fax:586-777-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBN407585261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P29050Medicare PIN