Organization Active NPI

Doctors of Internal Medicine PLLC

  • Internal Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1194244715
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DOCTORS OF INTERNAL MEDICINE PLLC
Practice address
30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2262
Phone
(248) 626-6500
Fax
(248) 855-0190
NPI assigned
Sep 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Steven D Grant, MDNPI 1770564692
Title
Sole MBR
Phone
(248) 626-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2262

Mailing address

30335 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2262
Phone (248) 626-6500

Other identifiers 1

IdentifierTypeStateIssuer
1311041MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171229001553 MI Part B Supplier - Clinic/Group Practice 7416215165 Receives reassigned benefits from 1 practitioner
Practice locations: Farmington Hills, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194244715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30335 W 13 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342262",
            "telephone_number": "248-626-6500",
            "fax_number": "248-855-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30335 W 13 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342262",
            "telephone_number": "248-626-6500",
            "fax_number": "248-855-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS OF INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "248-626-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311041",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.