Conant Medical Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301059824 Issued in MI

Legal business name

CONANT MEDICAL CENTER PLLC

Practice address

25529 Van Dyke Ave
Suitea
Center Line, MI 48015-1848

Phone

(586) 806-5977

Fax

(586) 806-5985

NPI assigned

Jun 25, 2007

Last updated

May 18, 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. Alexander Vertkin, M.D.

Title

Owner

Phone

(586) 806-5977

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1326244450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25529 VAN DYKE AVE",
            "address_2": "SUITEA",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151848",
            "telephone_number": "586-806-5977",
            "fax_number": "586-806-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25529 VAN DYKE AVE",
            "address_2": "SUITEA",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151848",
            "telephone_number": "586-806-5977",
            "fax_number": "586-806-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONANT MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "VERTKIN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-806-5977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301059824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4425780",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Center Line, MI
• Providers in Center Line, 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 May 18, 2009; 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.