Organization
MICHIGAN REPRODUCTIVE MEDICINE
Active
Other names
Center for Reproductive Medicine and Surgery, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO MERSOL-BARG MPA (MANAGER)
(248) 972-0877
Entity
Organization
Contact information
Practice address
41000 WOODWARD AVE, SUITE 100 EAST, BLOOMFIELD HILLS, MI 48304-5130
(248) 593-6990
(248) 593-5925
Mailing address
2830 MEADOWOOD LN, BLOOMFIELD, MI 48302-1029
(248) 972-0877
(248) 972-0880
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
MM0056302
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0633272
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
14367A
HEALTH ALLIANCE PLAN
MI
Enumeration date
04/29/2009
Last updated
10/08/2013
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