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MINDSHAPE CLINIC PLC NPI 1174303077


NPI Information

NPI: 1174303077
Provider Name: MINDSHAPE CLINIC PLC

Other Name: MINDSHAPE CLINIC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
3808 GATWICK DR
TROY, MI
ZIP 48083
Phone: (515) 650-3031
Get Directions

MINDSHAPE CLINIC PLC is an internal medicine in Troy, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MINDSHAPE CLINIC PLC NPI is 1174303077. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mindshape Clinic.

The provider's business location address is:

3808 GATWICK DR
TROY, MI
ZIP 48083-173
Phone: (515) 650-3031

The provider's authorized official is Hassan A Khan .
The authorized official title is Ceo/founder and has the following contact phone number (515) 650-3031.

The enumeration date for this NPI number is 9/29/2023 and was last updated on 11/16/2023.


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
1207R00000XInternal MedicineYes

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
100427241MEDICAIDNORTH CAROLINA
27100785550MEDICAIDKENTUCKY

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

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