# MID MICHIGAN OBSTETRICS & GYNECOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295889004
- **Authorized official:** DR. SCOTT ALLEN THIELE MD (OWNER)
- **Authorized official phone:** (989) 631-6730

## Contact information

- **Practice address:** 3016 W WACKERLY ST, MIDLAND, MI 48640-6160
- **Practice address phone:** (989) 631-6730
- **Practice address fax:** (989) 631-4968
- **Mailing address:** 3016 W WACKERLY ST, MIDLAND, MI 48640-6160
- **Mailing address phone:** (989) 631-6730
- **Mailing address fax:** (989) 631-4968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | MI | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 08/22/2020