NPIMap

Organization Active NPI

Southeastern Michigan Services, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • Detroit, MI
National Provider Identifier
1558442830
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
SOUTHEASTERN MICHIGAN SERVICES, INC.
Practice address
17755 Winston St
Detroit, MI 48219-3078
Phone
(248) 979-2001
Fax
(313) 977-9750
NPI assigned
Oct 17, 2006
Last updated
May 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Mr. Adam Healy Mahar
Title
Ceo, Pres.,Chairman, Sec., Treas.
Phone
(248) 979-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary

Addresses

Primary practice location

17755 Winston St
Detroit, MI 48219-3078

Mailing address

17755 Winston St
Detroit, MI 48219-3078
Phone (248) 979-2001

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1558442830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17755 WINSTON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193078",
            "telephone_number": "248-979-2001",
            "fax_number": "313-977-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17755 WINSTON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193078",
            "telephone_number": "248-979-2001",
            "fax_number": "313-977-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MICHIGAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "MAHAR",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "HEALY",
        "authorized_official_title_or_position": "CEO, PRES.,CHAIRMAN, SEC., TREAS.",
        "authorized_official_telephone_number": "248-979-2001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.