Organization Active NPI

Regal Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Rochester Hills, MI
National Provider Identifier
1114006368
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
REGAL PEDIATRICS
Practice address
2502 S Rochester Rd
Rochester Hills, MI 48307-3817
Phone
(248) 852-5177
Fax
(248) 852-5424
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mahmound Elghoroury, M.D.
Title
Owner
Phone
(248) 852-5177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

2502 S Rochester Rd
Rochester Hills, MI 48307-3817

Mailing address

2502 S Rochester Rd
Rochester Hills, MI 48307-3817
Phone (248) 852-5177

Other identifiers 1

IdentifierTypeStateIssuer
3303835MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114006368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 S ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073817",
            "telephone_number": "248-852-5177",
            "fax_number": "248-852-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 S ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073817",
            "telephone_number": "248-852-5177",
            "fax_number": "248-852-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGAL PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELGHOROURY",
        "authorized_official_first_name": "MAHMOUND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-852-5177",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303835",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • 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.