Charles G. Godoshian, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

CG046652 Issued in MI

Legal business name

CHARLES G. GODOSHIAN, M.D., P.C.

Practice address

27177 Lahser Rd
Suite 104
Southfield, MI 48034-4714

Phone

(248) 353-0882

Fax

(248) 353-0883

NPI assigned

Jun 22, 2007

Last updated

Jun 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles G Godoshian, M.D.NPI 1699769190

Title

President

Phone

(248) 353-0882

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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.

• Charles G Godoshian, M.D.

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1699769190
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1215133673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27177 LAHSER RD",
            "address_2": "SUITE 104",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344714",
            "telephone_number": "248-353-0882",
            "fax_number": "248-353-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27177 LAHSER RD",
            "address_2": "SUITE 104",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344714",
            "telephone_number": "248-353-0882",
            "fax_number": "248-353-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES G. GODOSHIAN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "GODOSHIAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-353-0882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "CG046652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1731411",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0F38121",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kilisa R Chappell
• Cailynn Charara
• Andrew Emmanuel Chardavoine, MD
• Charisma Transportation Service LLC
• Leanda Charles
• Andre Charley, LMSW
• Chandra T Charlton, P.T.
• Kenisha Chase
• Gregory Chatman Jr.

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.