NPIMap

Organization Active NPI

Magnum Managment

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1013138494
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7021 Issued in MI
Legal business name
MAGNUM MANAGMENT
Practice address
17600 W 8 Mile Rd
Suite # 5
Southfield, MI 48075-4305
Phone
(248) 424-9749
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Dr. Larry H. Reid, D.O.
Title
President
Phone
(248) 424-9749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7021 MI Primary

Addresses

Primary practice location

17600 W 8 Mile Rd
Suite # 5
Southfield, MI 48075-4305

Mailing address

PO Box 48456
Oak Park, MI 48237-6056

National Provider Directory

National Provider Directory

Locations

17600 W 8 Mile Rd
Ste 5
Southfield, MI 48075
Phone (248) 424-9749

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1013138494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48456",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482376056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 W 8 MILE RD",
            "address_2": "SUITE # 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754305",
            "telephone_number": "248-424-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNUM MANAGMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-424-9749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "7021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.