Provider Demographics
NPI:1295479251
Name:COMPASSIONATE GYNECOLOGY OF MICHIGAN PLLC
Entity type:Organization
Organization Name:COMPASSIONATE GYNECOLOGY OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-430-8964
Mailing Address - Street 1:445 N FENWAY DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2666
Mailing Address - Country:US
Mailing Address - Phone:810-869-6086
Mailing Address - Fax:833-872-0085
Practice Address - Street 1:445 N FENWAY DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2666
Practice Address - Country:US
Practice Address - Phone:810-869-6086
Practice Address - Fax:833-872-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty