OrganizationActive
Great Lakes Urogynecology PLC
NPI 1144111840 · Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · Brownstown Twp, MI
Provider details
- NPI number
- 1144111840
- Entity type
- Organization
- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jaclyn Baratono, Authorized Official(734) 225-6859
Specialties & taxonomies
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianPrimary207VF0040X
Allopathic & Osteopathic Physicians
Practice location
19249 Allen Rd Ste B
Brownstown Twp, MI 48183-1189
Phone: (248) 835-2797
Approximate (ZIP-level) locationGet directions
Mailing address
19249 Allen Rd Ste B
Brownstown Twp, MI 48183-1189
Registry dates
- Enumerated
- 2025-07-10
- Last updated
- 2025-08-05
- Certified
- 2025-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.