Afd Medical PC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

4301035768 Issued in MI

Legal business name

AFD MEDICAL PC

Practice address

15945 19 Mile Rd
Suite 100
Clinton TWP, MI 48038-1109

Phone

(586) 263-0464

Fax

(586) 263-0961

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Friedrich Dutka, MD

Title

Officer

Phone

(586) 263-0464

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1114937299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-0464",
            "fax_number": "586-263-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381109",
            "telephone_number": "586-263-0464",
            "fax_number": "586-263-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFD MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DUTKA",
        "authorized_official_first_name": "FRIEDRICH",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "586-263-0464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301035768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4413690",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Clinton TWP, MI
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.