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Organization

LAKES OBGYN SPECIALIST

Active
Parent organization
MERCY HEALTH PARTNERS
Other names
Trinity Health Medical Group Obstetrics & Gynecology - Lake Village
Organization subpart
Yes

Provider details

NPI number
Legal business name
MERCY HEALTH PARTNERS
Authorized official
MICHAEL GUSHO (CHIEF FINANCIAL OFFICE)
(734) 398-0642
Entity
Organization

Contact information

Practice address
6401 PRAIRIE ST STE 1700, NORTON SHORES, MI 49444-7843
(231) 672-7939
Mailing address
PO BOX 776982, CHICAGO, IL 60677-6982
(800) 494-5797

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
367A00000X
Advanced Practice Midwife

Other

Enumeration date
10/18/2010
Last updated
03/05/2026
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