Elmwood Park Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101007577 Issued in MI

Legal business name

ELMWOOD PARK MEDICAL CLINIC PC

Practice address

2950 E Jefferson Ave
Detroit, MI 48207-4208

Phone

(313) 399-5083

NPI assigned

Jan 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. George Evans, DO

Title

Owner

Phone

(313) 399-5083

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1538407465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074208",
            "telephone_number": "313-399-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMWOOD PARK MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-399-5083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101007577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmhurst Home, Inc.
• Antonio Elmore Sr.
• Ranya Elmoursi, MA, TLLP
• Elmwood Geriatric Village, Inc
• Elmwood Park Dental
• Khaled Elnaggar
• Rahma Elnaghy, BDS, MORTHRCSED
• Ahmed Elnahla, M.D.
• Bria Elrod, MD
• Roy C Elrod, M.D.

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.