Individual provider Active NPI

Brian J Serlin, MD

  • Family Medicine Physician
  • Warren, MI
National Provider Identifier
1053438440
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014261 Issued in MI
Practice address
27070 Hoover Rd.
Suite B
Warren, MI 48093-4590
Phone
(615) 778-4066
Fax
(615) 778-9114
NPI assigned
Mar 23, 2007
Last updated
Apr 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101014261 MI Primary

Addresses

Primary practice location

27070 Hoover Rd.
Suite B
Warren, MI 48093-4590

Mailing address

5080 Spectrum Drive
Suite 1200 West Tower
Addison, TX 75001-4648
Phone (800) 232-3550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1053438440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DRIVE",
            "address_2": "SUITE 1200 WEST TOWER",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "800-232-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27070 HOOVER RD.",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934590",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERLIN",
        "first_name": "BRIAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; 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.