NPIMap

Organization Active NPI

Beaumont Medical Group- Specialty Services

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1093691065
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BEAUMONT MEDICAL GROUP- SPECIALTY SERVICES
Practice address
18200 Oakwood Blvd
Dearborn, MI 48124-5025
Phone
(947) 524-2760
NPI assigned
Aug 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Matthew E Cox
Title
Cfo
Phone
(616) 295-4264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

18200 Oakwood Blvd
Dearborn, MI 48124-5025

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Corewell Health Medical Group East Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaumont Medical Group- Specialty Services13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18200 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 438-7977

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1093691065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18200 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245025",
            "telephone_number": "947-524-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT MEDICAL GROUP- SPECIALTY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-295-4264"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.