Southfield Family Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301065663 Issued in MI

Legal business name

SOUTHFIELD FAMILY PRACTICE PLLC

Practice address

22972 Lahser Road
Southfield, MI 48033

Phone

(248) 353-4777

Fax

(248) 353-4235

NPI assigned

Aug 30, 2012

Organization subpart

No

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

Authorized official

Name

Mutahhar Ahmad, M.D.NPI 1134168388

Title

President

Phone

(248) 353-4777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mutahhar Ahmad, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Southfield, MI
  • NPI 1134168388
  Medicare reassignment Care Compare group NPD Authorized official
• Kermit E White, M.D.

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1528045903
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1306195730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22972 LAHSER ROAD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "248-353-4777",
            "fax_number": "248-353-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 LAHSER ROAD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "248-353-4777",
            "fax_number": "248-353-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MUTAHHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-353-4777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301065663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southfield Essential Care PLLC
• Southfield Family Dental Center
• Southfield Family Dental Center PLLC
• Southfield Family Foot Center, P.C.
• Southfield Family Physicians, PLLC
• Southfield Gastroenterology Associates PC
• Southfield Gum Docs, LLC
• Southfield Internists PC
• Southfield Kids Dentist PLC
• Southfield Medical Pharmacy Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.