Advanced Physician Group PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ADVANCED PHYSICIAN GROUP PLLC

Practice address

13530 Michigan Ave
Suite 400
Dearborn, MI 48126-3574

Phone

(313) 945-9800

Fax

(314) 667-6915

NPI assigned

Oct 22, 2014

Last updated

Oct 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melanie Maycock

Title

Billing Director

Phone

(734) 673-5917

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1083019848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE",
            "address_2": "SUITE 400",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263574",
            "telephone_number": "313-945-9800",
            "fax_number": "314-667-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE",
            "address_2": "SUITE 400",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263574",
            "telephone_number": "313-945-9800",
            "fax_number": "314-667-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICIAN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "MAYCOCK",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "734-673-5917"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.