Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Professional OBGYN PC

Organization Obstetrics & Gynecology Physician · NPI 1477602480

Professional OBGYN PC is an Obstetrics & Gynecology Physician in Walled Lake, Michigan. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

55 N Pond Dr Ste 2
Walled Lake, MI 48390-3080
Phone: (248) 624-3366
Fax: (248) 624-0127
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X

Record details

NPI number1477602480
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Kushner — President · (248) 476-4900
NPI enumeratedJanuary 9, 2007
Last updated in NPPESAugust 22, 2020
Mailing address20276 Middlebelt Rd, Suite 2, Livonia, MI 48152-2054

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