Professional OBGYN PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PROFESSIONAL OBGYN PC

Practice address

55 N Pond Dr
Suite 2
Walled Lake, MI 48390-3080

Phone

(248) 624-3366

Fax

(248) 624-0127

NPI assigned

Jan 9, 2007

Last updated

Aug 22, 2020By 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

Dr. Roger Kushner, D.O.NPI 1962467621

Title

President

Phone

(248) 476-4900

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Roger Matthew Kushner, D.O.

  • Obstetrics Physician
  • Livonia, MI
  • NPI 1962467621
  Authorized official Same address or phone
• Robert L Dock, DO

  • Obstetrics & Gynecology Physician
  • Livonia, MI
  • NPI 1689645137
  NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477602480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20276 MIDDLEBELT RD",
            "address_2": "SUITE 2",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522054",
            "telephone_number": "248-476-4900",
            "fax_number": "248-476-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N POND DR",
            "address_2": "SUITE 2",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903080",
            "telephone_number": "248-624-3366",
            "fax_number": "248-624-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OBGYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUSHNER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-476-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pillay Internal Medicine Associates, PLLC
• Jeet N Pillay, MD
• Pontiac Trail Pharmacy Inc (Pontiac Trail Medical Pharmacy)
• James Cleary Powers
• Pristine Medical LLC
• Amy Kathleen Pruneau, LLP
• Christina Sharon Dhanam Reuben
• Rick J Deroven DDS PC
• Ryan P Rivamonte, DDS
• Regina Elizabeth Rizk, MD

• Obstetrics & Gynecology Physician in Walled Lake, MI
• Providers in Walled Lake, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.