SOUTHFIELD FAMILY PRACTICE PLLC (NPI# 1306195730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306195730 |
| Entity Type | Organization |
| Organization Name | SOUTHFIELD FAMILY PRACTICE PLLC |
| Practice Address |
22972 Lahser Road Southfield MI 48033 |
| Practice Telephone | 2483534777 |
| Practice Fax Number | 2483534235 |
| Mailing Telephone | 2483534777 |
| Mailing Fax Number | 2483534235 |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |
| Authorized Official Name | MUTAHHAR AHMAD (PRESIDENT) |
| Authorized Official Telephone | 2483534777 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301065663 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
22972 LAHSER ROAD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699398081 | Natalie Bacheldor | Family Medicine | 22250 Providence Drive Suite 557, Southfield, MI 48075-4818 | 2020-05-20 |
| 1346806734 | Michigan Visiting Physician Services, Inc | Family Medicine | 21751 W 11 Mile Rd Ste 204, Southfield, MI 48076-3779 | 2019-05-12 |
| 1174031942 | Providence Homecare Providers Pllc | Family Medicine | 25511 Southfield Rd Ste 118, Southfield, MI 48075-1830 | 2018-01-16 |
| 1225567944 | Bilal Tarek Malek | Family Medicine | 23648 Lahser Rd, Southfield, MI 48033-3250 | 2017-06-06 |
| 1457894461 | Residential Physicians Association, Pllc | Family Medicine | 28300 Franklin Rd Ste 100, Southfield, MI 48034-1657 | 2016-11-22 |
| 1194104885 | Lorenzo Ray Mata Lim | Family Medicine | 23077 Greenfield Rd Ste 195, Southfield, MI 48075-3750 | 2015-05-27 |
| 1194147959 | Premier Family Medicine Pllc | Family Medicine | 23031 Wrexford Dr, Southfield, MI 48033-6575 | 2014-01-14 |
| 1760745434 | Latoya Tamara Austin | Family Medicine | 22250 Providence Dr Ste 557, Southfield, MI 48075-4825 | 2012-06-19 |
| 1508124082 | Thomas Mays Md, PC | Family Medicine | 20905 Greenfield Rd Ste 201, Southfield, MI 48075-5346 | 2012-05-02 |
| 1457644163 | Associated Medical Inc | Family Medicine | 17100 W 12 Mile Rd, Suite 1, Southfield, MI 48076-2115 | 2011-05-27 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
Please comment or provide details below to improve the information on SOUTHFIELD FAMILY PRACTICE PLLC.
| 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.