Organization
GROSSE PTE OBSTETRICS & GYN PC
Active
Other names
Grosse Pointe Ob &Gyn
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRAZYNA KRYSTINA ZAJDEL M.D. (CORPORATION PRESIDENT)
(313) 882-6780
Entity
Organization
Contact information
Practice address
25910 KELLY RD, STE 9, ROSEVILLE, MI 48066-4466
(586) 779-6222
(586) 779-6228
Mailing address
25910 KELLY RD, STE 9, ROSEVILLE, MI 48066-4466
(586) 779-6222
(586) 779-6228
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
GZ051612
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0360747
ACOG NUMBER
MI
01
—
1608250512
BCBS NUMBER
MI
05
—
3383620
—
MI
01
—
A78218
HAP PROVIDER NUMBER
MI
01
—
GZ051612
MI STATE LICENSE
MI
Enumeration date
11/30/2006
Last updated
12/15/2009
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