Midwest Medical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MIDWEST MEDICAL LAB LLC

Practice address

307 Stewart Rd
Monroe, MI 48162-4393

Phone

(313) 544-3614

NPI assigned

Aug 11, 2017

Last updated

Aug 11, 2017By 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

Fouad Baydoun

Title

Manager

Phone

(313) 544-3614

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502409600000",
    "number": "1417472382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624393",
            "telephone_number": "313-544-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-11",
        "last_updated": "2017-08-11",
        "status": "A",
        "authorized_official_last_name": "BAYDOUN",
        "authorized_official_first_name": "FOUAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-544-3614"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James A Miller, D.O.
• Kris Ann Miller, CRNA

• Clinical Medical Laboratory in Monroe, MI
• Providers in Monroe, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; 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.