BIRMINGHAM ROYAL OAK MEDICAL GROUP PC (NPI# 1679806996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679806996 |
| Entity Type | Organization |
| Organization Name | BIRMINGHAM ROYAL OAK MEDICAL GROUP PC |
| Practice Address |
5130 Coolidge Hwy Royal Oak MI 48073-1001 |
| Practice Telephone | 2482889500 |
| Practice Fax Number | 2482880044 |
| Mailing Telephone | 2482889500 |
| Mailing Fax Number | 2482880044 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |
| Authorized Official Name | DR. MUMTAZ GEORGE (OWNER MEDICAL DIRECTOR PHYSICIAN) |
| Authorized Official Telephone | 2482889500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
4301038490 | MI | Ambulatory Health Care Facilities |
| Street Address |
5130 COOLIDGE HWY |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922094689 | Kenneth Wayne Gahry | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2005-09-27 |
| 1679921787 | Maegen Mandeville | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2016-05-31 |
| 1437544772 | Royal Oak Medical Center PC | Internal Medicine | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2015-04-03 |
| 1477974103 | Kanupriya Kapoor | Physical Therapist | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2013-12-24 |
| 1952737645 | Martin Zarski | Nurse Anesthetist, Certified Registered | 5130 Coolidge Hwy, Suite 120, Royal Oak, MI 48073-1001 | 2013-09-25 |
| 1417389396 | David Vandam LLC | Nurse Anesthetist, Certified Registered | 5130 Coolidge Hwy, Suite 120, Royal Oak, MI 48073-1001 | 2013-08-02 |
| 1720429251 | Margarete Liles LLC | Nurse Anesthetist, Certified Registered | 5130 Coolidge Hwy, Suite 120, Royal Oak, MI 48073-1001 | 2013-07-12 |
| 1881032407 | Maureen Therese Romanchik | Nurse Practitioner | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2013-06-05 |
| 1619228061 | Kelly L Hess | Nurse Practitioner | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2012-09-25 |
| 1922396936 | Rashmi Patel | Physical Therapist | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2011-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
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| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
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|---|---|---|---|---|
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1144542390 | Cedar Medical Services PC | Clinic/Center | 1010 N Campbell Rd, Suite 3, Royal Oak, MI 48067-1570 | 2010-02-15 |
| 1316087331 | Early Solutions Clinic, LLC | Clinic/Center | 5150 Coolidge Hwy, Royal Oak, MI 48073-1025 | 2007-02-07 |
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| 1225679822 | The Urgent Care PC | Clinic/Center | 170 W Genesee St Ste B, Frankenmuth, MI 48734-1305 | 2019-10-04 |
| 1508417197 | Vps of Mi Pllc | Clinic/Center | 25880 Outer Dr Ste 1, Lincoln Park, MI 48146-1553 | 2019-09-25 |
| 1356804710 | Southshore Urgent Care Pllc. | Clinic/Center | 20789 Gibraltar Rd, Brownstown Twp, MI 48183-5087 | 2019-04-11 |
| 1871054650 | Warren Urgent Care Walk-in Clinic LLC | Clinic/Center | 30736 Hoover Rd, Warren, MI 48093-2555 | 2019-03-26 |
| 1821553587 | Medpointe Urgent Care Walk In Clinic PC | Clinic/Center | 31290 Groesbeck Hwy, Fraser, MI 48026-2517 | 2019-02-07 |
| 1174088066 | Kb Care, Pllc | Clinic/Center | 4563 Washtenaw Ave Ste B, Ann Arbor, MI 48108-1011 | 2019-02-05 |
| 1700340569 | Nuch of Michigan, Inc. | Clinic/Center | 20782 Thirteen Mile Road, Roseville, MI 48375 | 2019-01-25 |
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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.