Organization
MODERN OBSTETRICS & GYNECOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY E FISHER MD (PHYSICIAN/ PRESIDENT)
(248) 862-7221
Entity
Organization
Contact information
Practice address
5793 W MAPLE RD STE 147, WEST BLOOMFIELD, MI 48322-4478
(248) 862-7221
(248) 970-2941
Mailing address
5793 W MAPLE RD STE 147, WEST BLOOMFIELD, MI 48322-4478
(248) 862-7221
(248) 970-2941
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
05/07/2008
Last updated
02/04/2019
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