Individual provider Active NPI

Gloria Chemaly, M.D.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1376717256
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301099363 Issued in MI
Practice address
9938 Harper Ave
Detroit, MI 48213-3110
Phone
(313) 921-2100
Fax
(313) 921-2106
NPI assigned
Apr 22, 2008
Last updated
Jan 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301099363 MI Primary

Addresses

Primary practice location

9938 Harper Ave
Detroit, MI 48213-3110

Mailing address

9938 Harper Ave
Detroit, MI 48213-3110
Phone (313) 921-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181102000267 SC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4981830015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301099363MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
RX Mart Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1376717256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9938 HARPER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133110",
            "telephone_number": "313-921-2100",
            "fax_number": "313-921-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9938 HARPER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133110",
            "telephone_number": "313-921-2100",
            "fax_number": "313-921-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEMALY",
        "first_name": "GLORIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301099363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.