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CHERYL GIBSON FOUNTAIN M.D.
NPI 1184612574
Obstetrics & Gynecology in Grosse Pointe Park, MI

Active since October 10, 2005
15050 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230(313) 823-4682(313) 823-8022 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cheryl Gibson Fountain M.d. NPPES

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

CHERYL GIBSON FOUNTAIN M.D. (NPI 1184612574) is an individual obstetrics & gynecology provider in Grosse Pointe Park, Michigan, licensed in Michigan (4301052473) and active in the NPI registry since October 2005. She maintains a secondary practice location in Saint Clair Shores.

NPPES Registry Identity

NPI1184612574
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameCHERYL GIBSON FOUNTAINCredential: M.D.
Location Address15050 E JEFFERSON AVEGrosse Pointe Park, MI 48230-2050
Mailing Address43800 Garfield RdClinton Twp, MI 48038-1136 · (800) 848-0202 · Fax (586) 226-6949
Phone(313) 823-4682
Fax(313) 823-8022
Sole ProprietorNo
Enumeration DateOctober 10, 2005
Last NPPES UpdateOctober 22, 2020
NPPES CertifiedOctober 22, 2020
✔ NPI 1184612574 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 · 4301052473
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.
15050 E JEFFERSON AVE, Grosse Pointe Park, MI 48230
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Secondary Practice Location 1

Location 121400 E 11 Mile RdSaint Clair Shores, MI 48081-1566 · Phone (586) 498-4400

Other Identifiers 3

Medicaid4502234MI
Other700H249730MI · Bcbs Group Number
Medicaid4417616MI

Other Providers at the Same Location NPPES 2

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

KRISTINE MARIE BALAVITCH PA
Physician Assistant
15050 E JEFFERSON AVE
GROSSE POINTE PARK, MI 48230
Wayne County (248) 938-0141
DURGA MULPURI MD
Family Medicine
15050 E JEFFERSON AVE
GROSSE POINTE PARK, MI 48230
Wayne County (313) 823-4682

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 Cheryl Gibson Fountain's NPI number?

The NPI number for Cheryl Gibson Fountain is 1184612574. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Cheryl Gibson Fountain located?

Cheryl Gibson Fountain practices at 15050 E Jefferson Ave, Grosse Pointe Park, MI 48230. The listed phone number is (313) 823-4682.

What is Cheryl Gibson Fountain'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 Cheryl Gibson Fountain was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.