Organization
OBGYN SPECIALTY GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED C AUSTIN II MD (OWNER)
(313) 345-3144
Entity
Organization
Contact information
Practice address
19830 JAMES COUZENS FWY, DETROIT, MI 48235-1938
(313) 345-3144
(313) 345-3458
Mailing address
19830 JAMES COUZENS FWY, DETROIT, MI 48235-1938
(313) 345-3144
(313) 345-3458
Taxonomy
Speciality
Code
Description
License number
State
207VH0002X
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
Primary
AA033474
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-0H21245-0
BCBSM
MI
05
—
2994435-10
—
MI
Enumeration date
05/23/2007
Last updated
10/16/2007
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