Physicians Resources Network, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301030215 Issued in MI

Legal business name

PHYSICIANS RESOURCES NETWORK, PC

Practice address

7795 Elizabeth Lake Rd
Waterford, MI 48327-3603

Phone

(248) 698-3129

Fax

(248) 698-3129

NPI assigned

May 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wally Sherman Mahar, M.D.

Title

Ceo, Cfo, Chairman of the Board

Phone

(248) 698-3129

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1497960447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7795 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273603",
            "telephone_number": "248-698-3129",
            "fax_number": "248-698-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7795 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273603",
            "telephone_number": "248-698-3129",
            "fax_number": "248-698-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS RESOURCES NETWORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MAHAR",
        "authorized_official_first_name": "WALLY",
        "authorized_official_middle_name": "SHERMAN",
        "authorized_official_title_or_position": "CEO, CFO, CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "248-698-3129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301030215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN CORPORATION ID",
            "identifier": "00575Y",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Christine Pfeifle, PA-C
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• Caroline Ruth Pianki
• Bethany Piccinato, LMSW
• Brandy Leigh Pickens, MSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.