NPIMap

Organization Active NPI

Great Lakes Cancer MGMT Specialists

Doing business as Jerome E Seid MD

  • Non-Pharmacy Dispensing Site
  • Utica, MI
National Provider Identifier
1427155357
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
4301056352 Issued in MI
Legal business name
GREAT LAKES CANCER MGMT SPECIALISTS
Doing business as
Jerome E Seid MD
Practice address
11051 Hall Rd
Ste 120
Utica, MI 48317-5735
Phone
(586) 991-0700
Fax
(586) 991-0701
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roxanne Clark
Title
Chief Financial Officer
Phone
(313) 884-5524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 4301056352 MI Primary

Addresses

Primary practice location

11051 Hall Rd
Ste 120
Utica, MI 48317-5735

Mailing address

11051 Hall Rd
Ste 120
Utica, MI 48317-5735

Other identifiers 2

IdentifierTypeStateIssuer
4231200MedicaidMI
2367159OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • JEROME E SEID MD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daniel J Lehman MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11051 Hall Rd
Ste 120
Utica, MI 48317
Phone (586) 323-0301

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427155357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11051 HALL RD",
            "address_2": "STE 120",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11051 HALL RD",
            "address_2": "STE 120",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175735",
            "telephone_number": "586-991-0700",
            "fax_number": "586-991-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES CANCER MGMT SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "313-884-5524"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MI",
            "license": "4301056352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4231200",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2367159",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEROME E SEID MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Utica, MI

Sources for this page

  • 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.