Great Lakes Medical Center PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

GREAT LAKES MEDICAL CENTER PC

Practice address

27500 Hoover Rd
Warren, MI 48093-4586

Phone

(586) 427-4453

Fax

(586) 427-5573

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Linda H. Starr

Title

Director

Phone

(317) 598-8880

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508955816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33006 7 MILE RD",
            "address_2": "#176",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521358",
            "telephone_number": "586-427-4453",
            "fax_number": "586-427-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27500 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934586",
            "telephone_number": "586-427-4453",
            "fax_number": "586-427-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "317-598-8880",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• 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.