NPIMap

Organization Active NPI

Home Visit MD PLC

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1205964012
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301080385 Issued in MI
Legal business name
HOME VISIT MD PLC
Doing business as
Home Visit M.D., PLC
Practice address
26206 W 12 Mile Rd
Ste 302
Southfield, MI 48034-8501
Phone
(248) 440-6090
Fax
(248) 440-6094
NPI assigned
Mar 1, 2007
Last updated
Mar 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Authorized official

Name
Dr. Reginald N Eburuche Sr., MDNPI 1932189958
Title
Owner
Phone
(248) 440-6090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301080385 MI Primary

Addresses

Primary practice location

26206 W 12 Mile Rd
Ste 302
Southfield, MI 48034-8501

Mailing address

P. O. Box 250077
Franklin, MI 48025
Phone (248) 440-6090

Other names 1

  • HOME VISIT M.D., PLC Doing business as

National Provider Directory

National Provider Directory

Locations

1385 E 12 Mile Rd
Ste 200
Madison Hts, MI 48071
Phone (248) 284-1760

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1205964012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 250077",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "48025",
            "telephone_number": "248-440-6090",
            "fax_number": "248-440-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26206 W 12 MILE RD",
            "address_2": "STE 302",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348501",
            "telephone_number": "248-440-6090",
            "fax_number": "248-440-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME VISIT MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "EBURUCHE",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-440-6090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOME VISIT M.D., PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.