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SILVER LAKE FAMILY PRACTICE LLC NPI 1124208608


NPI Information

NPI: 1124208608
Provider Name: SILVER LAKE FAMILY PRACTICE ,LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D1037086

Address:
1100 TORREY RD STE 300
FENTON, MI
ZIP 48430
Phone: (810) 714-7369
Get Directions

SILVER LAKE FAMILY PRACTICE ,LLC is a family medicine in Fenton, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SILVER LAKE FAMILY PRACTICE ,LLC NPI is 1124208608. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1100 TORREY RD STE 300
FENTON, MI
ZIP 48430-327
Phone: (810) 714-7369
Fax: (810) 714-9258

The provider's authorized official is Donna S Benford .
The authorized official title is Owner and has the following contact phone number (810) 714-7369.

The CLIA number assigned to this NPI record is 23D1037086 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/13/2007 and was last updated on 11/13/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineDB009523MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10P12000MEDICARE PINMICHIGAN
24721123MEDICAIDMICHIGAN
3B45027MEDICARE UPINMICHIGAN
40P12010MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.