Fenkell Medical Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4301045264 Issued in MI

Legal business name

FENKELL MEDICAL CLINIC LLC

Practice address

10101 Fenkell St
Detroit, MI 48238-1645

Phone

(810) 423-2308

NPI assigned

Apr 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ramesh L Chheda, MD

Title

Owner

Phone

(810) 423-2308

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1104069301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27950 ORCHARD LAKE RD",
            "address_2": "STE 116",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381645",
            "telephone_number": "810-423-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENKELL MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "CHHEDA",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-423-2308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301045264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1867240 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UNSP",
            "identifier": "OP24500",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• La Wanda Felton
• Pamela Rene Femster
• Alethea Fenderson, RN
• Carol Lynn Feng, MD
• Matthew C Fenigstein, DDS
• Fenkell RX Pharmacy LLC
• Jeanna Yasim Fenn
• Sheral Lamar Fenn
• Danielle Alissa-Madden Fenningsdorf, LLMSW
• Kenya Michelle Fentress

• Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.