Coolmac Medical PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301043240 Issued in MI

Legal business name

COOLMAC MEDICAL PC

Practice address

14825 W McNichols Rd
Detroit, MI 48235-3939

Phone

(313) 838-7900

Fax

(313) 838-3476

NPI assigned

Jul 31, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Pramod Raval, M.D.

Title

President

Phone

(313) 838-7900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1477809242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28712 WINTERGREEN",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313018",
            "telephone_number": "313-838-7900",
            "fax_number": "313-838-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353939",
            "telephone_number": "313-838-7900",
            "fax_number": "313-838-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOLMAC MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "RAVAL",
        "authorized_official_first_name": "PRAMOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-838-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301043240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301043240",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0631385",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Cooley, MD
• Charmayne Gail Cooley, MD
• Demetrius Cooley
• Kijana Cooley
• Shekira S Cooley
• Katherine Shoush Cools, MD
• Michael Jacob Cools, MD
• Victoria Coombe
• Kadejah Dorena Coon
• Jessica Cooney, CPNP

• Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.