NPIMap

Organization Active NPI

Royal Oak Medical Center PC

  • Internal Medicine Physician
  • Royal Oak, MI
National Provider Identifier
1437544772
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301038490 Issued in MI
Legal business name
ROYAL OAK MEDICAL CENTER PC
Practice address
5130 Coolidge Hwy
Royal Oak, MI 48073-1001
Phone
(248) 288-9500
Fax
(248) 288-0044
NPI assigned
Apr 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Diane Dietrick
Title
Practice Admin
Phone
(248) 288-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301038490 MI Primary

Addresses

Primary practice location

5130 Coolidge Hwy
Royal Oak, MI 48073-1001

Mailing address

5130 Coolidge Hwy
Royal Oak, MI 48073-1001
Phone (248) 288-9500

National Provider Directory

National Provider Directory
Tax ID family
Royal Oak Medical Center PC2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1437544772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731001",
            "telephone_number": "248-288-9500",
            "fax_number": "248-288-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731001",
            "telephone_number": "248-288-9500",
            "fax_number": "248-288-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL OAK MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "DIETRICK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "248-288-9500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301038490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.