NPIMap

Organization Active NPI

Regents of the University of Michigan-Pediatric Surgery Offsite

  • Neurology with Special Qualifications in Child Neurology Physician
  • Grand Blanc, MI
National Provider Identifier
1003069139
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN-PEDIATRIC SURGERY OFFSITE
Practice address
4642 Genesys Parkway
Grand Blanc, MI 48439-8067
Phone
(810) 606-5830
NPI assigned
Nov 3, 2008
Last updated
Nov 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David A Spahlinger, MD
Title
Exec Medical Director Faculty GRP
Phone
(734) 936-3568

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X NU Primary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X NU
Sports Medicine (Psychiatry & Neurology) Physician 2084S0010X NU

Addresses

Primary practice location

4642 Genesys Parkway
Grand Blanc, MI 48439-8067

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of Michigan-Pediatric Surgery Offsite5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1003069139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4642 GENESYS PARKWAY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398067",
            "telephone_number": "810-606-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN-PEDIATRIC SURGERY OFFSITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "SPAHLINGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXEC MEDICAL DIRECTOR FACULTY GRP",
        "authorized_official_telephone_number": "734-936-3568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0010X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.