MICHIGAN PHYSICIANS GROUP, PC (NPI# 1164739066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164739066 |
| Entity Type | Organization |
| Organization Name | MICHIGAN PHYSICIANS GROUP, PC |
| Practice Address |
2025 W Long Lake Rd Suite 106 Troy MI 48098-4100 |
| Mailing Address |
30855 John R Rd Madison Heights MI 48071-5213 |
| Practice Telephone | 2489521540 |
| Practice Fax Number | 2485416862 |
| Mailing Telephone | 2485830100 |
| Mailing Fax Number | 2485834894 |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2011-05-04 |
| Authorized Official Name | MR. DINESH SHAH (MEDICAL DOCTOR/OWNER) |
| Authorized Official Telephone | 2485830100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
4301066469 | MI | Allopathic & Osteopathic Physicians |
| N | 213E00000X | Podiatrist | 5315028842 | MI | Podiatric Medicine & Surgery Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301065276 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | OF36177 | 01 |
| MEDICARE DME PTAN | 6388420003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518041052 | Michigan Physicians Group, PC | Family Medicine | 2905 12 Mile Rd, Berkley, MI 48072-1413 | 2006-10-24 |
| 1134436033 | Michigan Physicians Group, PC | Psychiatry & Neurology | 14325 Middlebelt Rd, Livonia, MI 48154-4541 | 2010-09-13 |
| Street Address |
2025 W LONG LAKE RD SUITE 106 |
| City | TROY |
| State | MI |
| Zip Code | 48098-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134221666 | Douglas L Sweeney | Dentist | 2025 W Long Lake Rd, Suite 112, Troy, MI 48098-4100 | 2006-09-04 |
| 1437559739 | Kerry J Brown, Dds | Clinic/Center | 2025 W Long Lake Rd, Suite 110, Troy, MI 48098-4100 | 2014-08-25 |
| 1285060715 | Spencer Brown | Dentist | 2025 W Long Lake Rd, Suite 110, Troy, MI 48098-4100 | 2013-09-16 |
| 1538237425 | Kerry James Brown | Dentist | 2025 W Long Lake Rd, Suite 110, Troy, MI 48098-4100 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053949289 | Douglas Ross | Physical Therapy Assistant | 4062 Livernois Rd, Troy, MI 48098 | 2020-04-01 |
| 1104382837 | Minxes Inc | Chiropractor | 1175 W. Long Lake Rd, Suite 100, Troy, MI 48098 | 2019-02-19 |
| 1689160053 | Nyssa J Swanson | Physical Therapist | 5440 Corporate Dr Ste 400, Troy, MI 48098 | 2018-07-09 |
| 1447742580 | Rebecca Jane Stros | Counselor | 900 Tower Dr, Troy, MI 48098 | 2018-06-05 |
| 1356863278 | Brigette Johnson | Occupational Therapist | 4794 Riverchase Dr, Troy, MI 48098 | 2017-07-12 |
| 1912448382 | Devyn Depeter | Technician/Technologist | 5877 Livernois Rd Ste 104, Troy, MI 48098 | 2017-03-17 |
| 1285025015 | Rochester Knee & Sports Medicine PC | Durable Medical Equipment & Medical Supplies | 4600 Investment Dr Ste 120, Troy, MI 48098 | 2015-02-16 |
| 1649690231 | Tammy Beesley-schick | Registered Nurse | 4568 Odette Ct, Troy, MI 48098 | 2014-04-22 |
| 1306269584 | Medi-care | Ambulance | 5741 Faircastle, Troy, MI 48098 | 2014-01-24 |
| 1881953644 | Diane Marie Bald | Social Worker | 1707 White Birch Ct, Troy, MI 48098 | 2012-05-14 |
| Find all providers in zip 48098 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972051530 | Michael Abdul-malek Do Pllc | Internal Medicine | 1380 Coolidge Hwy Ste 250, Troy, MI 48084-7067 | 2016-09-13 |
| 1104125756 | Ibin Sina Cardiovascular Center PC | Internal Medicine | 2678 Melcombe Cir, 104, Troy, MI 48084-3457 | 2011-03-22 |
| 1891946703 | Ruslan Feygin | Internal Medicine | 2231 Burdett Ave Ste 160, Capital Cardiology Associates PC, Troy, NY 12180-2453 | 2008-10-09 |
| 1124187307 | Vina R. Patel | Internal Medicine | 763 Hoosick Road, Troy, NY 12180-6646 | 2006-12-06 |
| 1154422236 | Hussain A Khawaja | Internal Medicine | 258 Hoosick St Ste 107, Tri-city Cardiology Care, Pllc, Troy, NY 12180-2471 | 2006-09-25 |
| 1255371605 | Scott Jeffrey Denardo | Internal Medicine | 522 Allen St Ste 101, Troy, NC 27371-2861 | 2006-06-07 |
| 1487615241 | Rodrigo G Goh | Internal Medicine | 172 Professional Parkway, Po Box A, Troy, MO 63379-1520 | 2006-03-31 |
| 1104898667 | Maria Theresa Pacis Biederman | Internal Medicine | 3310 W Big Beaver Rd, Suite 137, Troy, MI 48084-2809 | 2006-02-07 |
| 1366420069 | Elizabeth Renukarani Claudius | Internal Medicine | 522 Allen St, Suite 101, Troy, NC 27371-2861 | 2006-01-04 |
| 1033192083 | Renato G Ramos | Internal Medicine | 1559 W Big Beaver Rd, Ste E, Troy, MI 48084-3525 | 2005-11-23 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.