Clarkston Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TD040084 Issued in MI

Legal business name

CLARKSTON MEDICAL CLINIC PC

Practice address

5790 S Main Street
Ste J
Clarkston, MI 48346

Phone

(248) 625-8220

Fax

(248) 625-6646

NPI assigned

Jan 30, 2007

Last updated

Aug 22, 2020By 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. Tarlika C Dhabuwala, MDNPI 1336194117

Title

President

Phone

(248) 625-8220

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tarlika Chirpriya Dhabuwala, MD

  • Internal Medicine Physician
  • Clarkston, MI
  • NPI 1336194117
  Authorized official Same address or phone

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396881827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5790 S MAIN STREET",
            "address_2": "STE J",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-625-8220",
            "fax_number": "248-625-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5790 S MAIN STREET",
            "address_2": "STE J",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-625-8220",
            "fax_number": "248-625-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DHABUWALA",
        "authorized_official_first_name": "TARLIKA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-625-8220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "TD040084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarkston Family Dental
• Clarkston Family Therapists LLC
• Clarkston Health Center
• Clarkston Internal Medicine, P.C.
• Clarkston Lakes Family Medicine LLC
• Clarkston Oaks Family Dentistry
• Clarkston Opco LLC (Villa at Pine Place)
• Clarkston Operating Company LLC (Clarkston Specialty Healthcare Center)
• Clarkston Pediatric Dentistry PLC
• Clarkston Urgent Care PLC

• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, 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 22, 2020; 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.