Michigan Physicians Group, PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301065276 Issued in MI

Legal business name

MICHIGAN PHYSICIANS GROUP, PC

Practice address

2025 W Long Lake Rd
Suite 106
Troy, MI 48098-4100

Phone

(248) 952-1540

Fax

(248) 541-6862

NPI assigned

Sep 13, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Dinesh Shah, MD

Title

Medical Doctor/Owner

Phone

(248) 583-0100

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1164739066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30855 JOHN R RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480715213",
            "telephone_number": "248-583-0100",
            "fax_number": "248-583-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W LONG LAKE RD",
            "address_2": "SUITE 106",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480984100",
            "telephone_number": "248-952-1540",
            "fax_number": "248-541-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PHYSICIANS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/OWNER",
        "authorized_official_telephone_number": "248-583-0100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301065276",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301066469",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5315028842",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "OF36177",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PTAN",
            "identifier": "6388420003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Medical Doctors PLLC
• Michigan Ophthalmology Specialists, PLLC
• Michigan Orthopaedic Surgeons PLLC (Michigan Orthopaedic Surgeons)
• Michigan Orthopaedic Surgeons PLLC
• Michigan Physical Therapy Specialists,PC
• Michigan Rehabilitation Specialists of Fowlerville, LLC (ATI Physical Therapy)
• Michigan Spine Institute, PC
• Michigan Telemed PLLC
• Ira Mickelson, MD
• Midwest Community Care Services LLC

• Cardiovascular Disease Physician in Troy, MI
• Providers in Troy, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.