Michigan Manual Physical Therapy PC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

4301044005 Issued in MI

Legal business name

MICHIGAN MANUAL PHYSICAL THERAPY PC

Practice address

28445 Van Dyke Ave
Warren, MI 48093-7132

Phone

(866) 708-6678

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Maynard Buszek, M.D.NPI 1003990037

Title

Owner - Ceo

Phone

(866) 708-6678

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Maynard Buszek, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Southfield, MI
  • NPI 1003990037

  Pain Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043389836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28445 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937132",
            "telephone_number": "866-708-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28445 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937132",
            "telephone_number": "866-708-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MANUAL PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSZEK",
        "authorized_official_first_name": "MAYNARD",
        "authorized_official_title_or_position": "OWNER - CEO",
        "authorized_official_telephone_number": "866-708-6678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "4301044005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Warren, MI
• Providers in Warren, MI by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.