Provider Demographics
NPI:1528294824
Name:OBSTETRICS AND GYNECOLOGY CENTER OF MICHIGAN, PLLC
Entity type:Organization
Organization Name:OBSTETRICS AND GYNECOLOGY CENTER OF MICHIGAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOUFIC
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEHBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-338-0414
Mailing Address - Street 1:44200 WOODWARD AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5045
Mailing Address - Country:US
Mailing Address - Phone:248-338-0414
Mailing Address - Fax:248-338-6185
Practice Address - Street 1:44200 WOODWARD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5045
Practice Address - Country:US
Practice Address - Phone:248-338-0414
Practice Address - Fax:248-338-6185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048163207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty