Divine Medical Center P C

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DIVINE MEDICAL CENTER P C

Practice address

901 W Grand Blvd
Detroit, MI 48208-2353

Phone

(313) 393-3141

Fax

(313) 393-3144

NPI assigned

Aug 6, 2012

Organization subpart

No

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

Authorized official

Name

Cermen Cardona, M.D

Title

President

Phone

(313) 393-3141

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1215284583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 806464",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480806464",
            "telephone_number": "313-393-3141",
            "fax_number": "313-393-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082353",
            "telephone_number": "313-393-3141",
            "fax_number": "313-393-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MEDICAL CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "CARDONA",
        "authorized_official_first_name": "CERMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-393-3141",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Concierge Solutions
• Divine Doula Goddess L.L.C
• Divine Life Home Care LLC
• Divine Living Homes
• Divine Medical Care
• Divine Mercyy Home Care
• Divine Pharmacy LLC
• Divine Rehab LLC
• Divine Touch Care Solutions LLC
• Divine Transformations, LLC

• General Practice Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.