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ASCENSION MEDICAL GROUP MICHIGAN NPI 1366515496


NPI Information

NPI: 1366515496
Provider Name: ASCENSION MEDICAL GROUP MICHIGAN
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 23D0716443

Address:
21000 E 12 MILE RD
SUITE 102
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (586) 447-5100
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ASCENSION MEDICAL GROUP MICHIGAN is an obstetrics gynecology in Saint Clair Shores, MI. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. ASCENSION MEDICAL GROUP MICHIGAN NPI is 1366515496. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

21000 E 12 MILE RD
SUITE 102
SAINT CLAIR SHORES, MI
ZIP 48081-116
Phone: (586) 447-5100
Fax: (586) 447-5090

The provider's authorized official is Sarah Starkel .
The authorized official title is Supervisor and has the following contact phone number (248) 680-8121.

The CLIA number assigned to this NPI record is 23D0716443 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/16/2006 and was last updated on 11/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyNo
2207VX0000XObstetrics & GynecologyObstetricsNo
3207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CG4683OTHERMICHIGANRAILROAD MEDICARE GROUP NUMBER
20E01168OTHERMICHIGANBCBSM GROUP NUMBER
30M92780OTHERMICHIGANMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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