Active NPI
Pedro Dumadag, MD
- Family Medicine Physician
- Southfield, MI
National Provider Identifier
1386623932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301048279
- Practice address
- 24681 Northwestern Hwy
Ste. 200
Southfield, MI 48075-2305 - Phone
- (248) 352-2000
- Fax
- (248) 352-8800
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301048279 | MI | Primary |
Addresses
Primary practice location
24681 Northwestern Hwy
Ste. 200
Southfield, MI 48075-2305
Mailing address
PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3108723 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa PC | Current | Accepting new patients |
Locations
500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Troy, MI
- NPI 1871666784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383782400000",
"number": "1386623932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1239",
"city": "TROY",
"state": "MI",
"postal_code": "480991239",
"telephone_number": "248-824-6600",
"fax_number": "248-324-1477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24681 NORTHWESTERN HWY",
"address_2": "STE. 200",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752305",
"telephone_number": "248-352-2000",
"fax_number": "248-352-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMADAG",
"first_name": "PEDRO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2013-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301048279",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3108723",
"state": "MI"
}
],
"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 Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.