Modern Obstetrics & Gynecology PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MODERN OBSTETRICS & GYNECOLOGY PLLC

Practice address

5793 W Maple Rd Ste 147
West Bloomfield, MI 48322-4478

Phone

(248) 862-7221

Fax

(248) 970-2941

NPI assigned

May 7, 2008

Last updated

Feb 4, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jay E Fisher, MDNPI 1811970171

Title

Physician/ President

Phone

(248) 862-7221

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jay E Fisher, MD

  • Obstetrics & Gynecology Physician
  • West Bloomfield, MI
  • NPI 1811970171
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1205002342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5793 W MAPLE RD STE 147",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224478",
            "telephone_number": "248-862-7221",
            "fax_number": "248-970-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5793 W MAPLE RD STE 147",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224478",
            "telephone_number": "248-862-7221",
            "fax_number": "248-970-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN OBSTETRICS & GYNECOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/ PRESIDENT",
        "authorized_official_telephone_number": "248-862-7221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.