Organization Active NPI

Universal Clinic P.C.

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1235131236
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSAL CLINIC P.C.
Practice address
18597 W 10 Mile Rd
Ste #1
Southfield, MI 48075-2663
Phone
(248) 569-5100
Fax
(248) 569-4774
NPI assigned
Aug 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Aleksandr Martirosov, D.O.NPI 1700931185
Title
Medical Director
Phone
(248) 752-4101

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

18597 W 10 Mile Rd
Ste #1
Southfield, MI 48075-2663

Mailing address

PO Box 198
Southfield, MI 48037-0198
Phone (248) 569-5100

National Provider Directory

National Provider Directory

Locations

39575 W 10 Mile Rd
Ste 102
Novi, MI 48375
Phone (246) 476-6980

18597 W 10 Mile Rd
Southfield, MI 48075
Phone (248) 395-2234

Practitioners & affiliated clinicians

Practitioners 7

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": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235131236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480370198",
            "telephone_number": "248-569-5100",
            "fax_number": "248-569-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18597 W 10 MILE RD",
            "address_2": "STE #1",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752663",
            "telephone_number": "248-569-5100",
            "fax_number": "248-569-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIROSOV",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-752-4101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.