MICHIGAN PHYSICIANS GROUP PC NPI 1518041052

NPI Information

NPI: 1518041052
Provider Name: MICHIGAN PHYSICIANS GROUP, PC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 23D0989642

Address:
2905 12 MILE RD
BERKLEY, MI
ZIP 48072
Phone: (248) 541-0770
Get Directions

MICHIGAN PHYSICIANS GROUP, PC is a cardiovascular disease internal medicine in Berkley, MI. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. MICHIGAN PHYSICIANS GROUP, PC NPI is 1518041052. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2905 12 MILE RD
BERKLEY, MI
ZIP 48072-413
Phone: (248) 541-0770
Fax: (248) 541-6862

The provider's authorized official is Dinesh Shah .
The authorized official title is President/owner and has the following contact phone number (313) 537-2107.

The CLIA number assigned to this NPI record is 23D0989642 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 4/26/2012.

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 State	Primary
1	207Q00000X	Family Medicine		MICHIGAN	No
2	363A00000X	Physician Assistant		MICHIGAN	No
3	213E00000X	Podiatrist		MICHIGAN	No
4	2084N0400X	Psychiatry & Neurology	Neurology	MICHIGAN	No
5	291U00000X	Clinical Medical Laboratory			No
6	332B00000X	Durable Medical Equipment & Medical Supplies			No
7	207RC0000X	Internal Medicine	Cardiovascular Disease	MICHIGAN	Yes

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
1	0F36177	OTHER	MICHIGAN	BCBSM
2	1518041052	MEDICAID	MICHIGAN
3	6388420001	OTHER		NATIONAL SUPPLIER CLEARINGHOUSE/NSC PTAN
4	0F38290	OTHER	MICHIGAN	BCBSM LABORATORY
5	0F36177	MEDICARE PIN

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

NPI Synchronization or Removal

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