Organization Active NPI

Grosse Pointe Comprehensive Care

  • Family Medicine Physician
  • Grosse Pointe Farms, MI
National Provider Identifier
1265756480
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301045243 Issued in MI
Legal business name
GROSSE POINTE COMPREHENSIVE CARE
Practice address
18348 Mack Ave
Grosse Pointe Farms, MI 48236-3219
Phone
(313) 881-7010
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Authorized official

Name
Carl Fowler, MD
Title
Medical Doctor
Phone
(313) 881-7010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 4301045243 MI Primary

Addresses

Primary practice location

18348 Mack Ave
Grosse Pointe Farms, MI 48236-3219

Mailing address

9600 Dexter Ave
Detroit, MI 48206-1816
Phone (313) 881-7010

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1265756480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 DEXTER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061816",
            "telephone_number": "313-881-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18348 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363219",
            "telephone_number": "313-881-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSE POINTE COMPREHENSIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "313-881-7010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301045243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.