Southfield Obsterical and Gynecologic Institute P.C.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

PH054677 Issued in MI

Legal business name

SOUTHFIELD OBSTERICAL AND GYNECOLOGIC INSTITUTE P.C.

Practice address

29275 Northwestern Hwy Ste 207
Southfield, MI 48034-5744

Phone

(248) 354-2201

Fax

(248) 354-2220

NPI assigned

Feb 3, 2017

Organization subpart

No

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

Authorized official

Name

Patrice L Harold

Title

M.D./ Owner

Phone

(248) 354-2201

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1770021354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 207",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345744",
            "telephone_number": "248-354-2201",
            "fax_number": "248-354-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 207",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345744",
            "telephone_number": "248-354-2201",
            "fax_number": "248-354-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD OBSTERICAL AND GYNECOLOGIC INSTITUTE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "HAROLD",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "M.D./ OWNER",
        "authorized_official_telephone_number": "248-354-2201"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "PH054677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4197245",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.