Cancer Genomic Consultants PC

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

Legal business name

CANCER GENOMIC CONSULTANTS PC

Practice address

1150 Heatherlea CT
Canton, MI 48188-6238

Phone

(734) 765-4282

NPI assigned

Apr 2, 2021

Organization subpart

No

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

Authorized official

Name

Dr. David Halverson, MD

Title

Ceo

Phone

(734) 765-4282

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1467031013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 HEATHERLEA CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886238",
            "telephone_number": "734-765-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 HEATHERLEA CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886238",
            "telephone_number": "734-765-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER GENOMIC CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "HALVERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-765-4282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Campbell, MD
• Caleb Harold Campbell, DDS
• Jessica Campbell
• Sophia Campbell, LMSW
• Tara Lor Campbell, LLPC, SCL
• Kayla Nicole Cane, MS, RDN, LDN
• Canton Ardent
• Canton ASC LLC
• Canton Asthma & Allergy PC
• Canton BCC LLC

• Medical Oncology Physician in Canton, MI
• Providers in Canton, MI by specialty
• Medical Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.