# NORTHVILLE OBGYN PC

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

## Provider details

- **NPI number:** 1659677946
- **Authorized official:** JYOTHI R NICHANAMETLA M.D. (OWNER)
- **Authorized official phone:** (734) 446-1045

## Contact information

- **Practice address:** 47311 FIVE MILE RD, PLYMOUTH, MI 48170-3768
- **Practice address phone:** (734) 446-1045
- **Practice address fax:** (734) 981-9028
- **Mailing address:** 47311 FIVE MILE RD, PLYMOUTH, MI 48170-3768
- **Mailing address phone:** (734) 446-1045
- **Mailing address fax:** (734) 981-9028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | MI | Yes |

## Other

- **Enumeration date:** 02/03/2011
- **Last updated:** 06/20/2018