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GATEWAY OBGYN ASSOCIATES PLLC
NPI 1134355902
Obstetrics & Gynecology in Detroit, MI

Active since June 06, 2009
2888 W GRAND BLVD, ST. 287, DETROIT, MI 48202(313) 875-4200 Get Directions Write a Review

NPPES record last updated: July 19, 2012. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Gateway Obgyn Associates Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GATEWAY OBGYN ASSOCIATES PLLC (NPI 1134355902) is a healthcare organization registered as an obstetrics & gynecology in Detroit, Michigan and active in the NPI registry since June 2009. The organization lists Theodore Kevin Graham, President, as its authorized official.

NPPES Registry Identity

NPI1134355902
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameGATEWAY OBGYN ASSOCIATES PLLC
Location Address2888 W GRAND BLVD, ST. 287Detroit, MI 48202-2612
Mailing Address2888 W Grand Blvd, St. 287Detroit, MI 48202-2612 · (313) 875-4200
Phone(313) 875-4200
Organization SubpartNo
Authorized OfficialTheodore Kevin GrahamPresident · (313) 875-4200
Enumeration DateJune 6, 2009
Last NPPES UpdateJuly 19, 2012
✔ NPI 1134355902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in MI · 4301050455
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
2888 W GRAND BLVD, Detroit, MI 48202
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE WELLNESS PLAN MEDICAL CENTERS
Clinic/Center
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-4200
RENEE FYFE CPSS & CPRC
Peer Specialist
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-4200
DMC CLINICAL LAB INC
Clinical Medical Laboratory
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 871-1200
BRIAN MANGENJE FNP-BC
Nurse Practitioner (Family)
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-4200
MRS. KIMBERLY LOUISE THORNTON RPH
Pharmacist
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-5614
MRS. DANITA MAYES DIXON FNP-C
Nurse Practitioner (Family)
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-4200
DR. KRYSTLE CHARON-WOODS HOLLIER PH.D.
Psychologist (Clinical)
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-5017
DR. JOSEPHINE N. BALATAN M.D.
Pediatrics
2888 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 875-5378

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gateway Obgyn Associates PLLC's NPI number?

The NPI number for Gateway Obgyn Associates PLLC is 1134355902. It was assigned to this organization in the NPPES registry on June 6, 2009.

Where is Gateway Obgyn Associates PLLC located?

Gateway Obgyn Associates PLLC is located at 2888 W Grand Blvd St. 287, Detroit, MI 48202. The listed phone number is (313) 875-4200.

What is Gateway Obgyn Associates PLLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Gateway Obgyn Associates PLLC was last updated on July 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.