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NPI 1306313515 Active Internal Medicine

Quick Facts

NPI Number

1306313515

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2018-10-25

Last Updated (NPPES)

2021-11-17

Primary Specialty / Taxonomy

Taxonomy	Internal Medicine
Taxonomy Code	`207R00000X`

Practice Address

6501 GREENFIELD RD
DETROIT, MI 482284780

Phone: 313-908-7464

Fax: 313-209-3002

Mailing Address

4 NOWLIN CT
DEARBORN, MI 481243912

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.