Organization
CATHERINE MCAULEY HEALTH SERVICES
Active
Parent organization
WESTSIDE OB/ GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTSIDE OB/ GYN
Authorized official
GARRY FAJA (PRESIDENT / CEO)
(734) 975-4101
Entity
Organization
Contact information
Practice address
5800 N LILLEY RD, CANTON, MI 48187-3668
(734) 981-2400
Mailing address
5800 N LILLEY RD, CANTON, MI 48187-3668
(734) 981-2400
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H11068
BCBS BCN
MI
01
—
0M78840
MEDICARE GROUP NUMBER
MI
Enumeration date
08/10/2007
Last updated
08/10/2007
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