Shores Diagnostic LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SHORES DIAGNOSTIC LLC

Practice address

3611 Carpenter St Ste 6
Hamtramck, MI 48212-2784

Phone

(313) 285-8728

Fax

(313) 784-9055

NPI assigned

Sep 28, 2020

Organization subpart

Yes

Parent organization

SHORES DIAGNOSTIC LLCAs reported in NPPES

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

Authorized official

Name

Norma Jean Barrett

Title

Billing Manager

Phone

(734) 730-7579

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shores Diagnostic Llc Former legal business name

Electronic endpoints 1

Part of

Shores Diagnostic LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Shores Diagnostic LLC

  • Radiology Clinic/Center
  • Warren, MI
  • NPI 1235110289
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muhammad Munir, MD

  • Cardiovascular Disease Physician
  • Royal Oak, MI
  • NPI 1124079553
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1033726633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 CARPENTER ST STE 6",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482122784",
            "telephone_number": "313-285-8728",
            "fax_number": "313-784-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 CARPENTER ST STE 6",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482122784",
            "telephone_number": "313-285-8728",
            "fax_number": "313-784-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORES DIAGNOSTIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHORES DIAGNOSTIC LLC",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "734-730-7579"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235110289",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "thectcenter8600@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Tufiqul",
            "address_1": "3611 Carpenter St Ste 6",
            "city": "Hamtramck",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482122784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shores Diagnostic Llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Hamtramck, MI
• Providers in Hamtramck, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.