NPIMap

Organization Active NPI

Six Mile Medical, PLLC

  • Clinic/Center
  • Detroit, MI
National Provider Identifier
1558631473
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4301091092 Issued in MI
Legal business name
SIX MILE MEDICAL, PLLC
Practice address
7145 W McNichols Rd
Detroit, MI 48221-2664
Phone
(313) 878-8454
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Fitzgerald Hudson, MD
Title
President
Phone
(313) 878-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4301091092 MI Primary

Addresses

Primary practice location

7145 W McNichols Rd
Detroit, MI 48221-2664

Mailing address

7145 W McNichols Rd
Detroit, MI 48221-2664
Phone (313) 878-8454

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1558631473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212664",
            "telephone_number": "313-878-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7145 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212664",
            "telephone_number": "313-878-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIX MILE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "FITZGERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-878-8454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301091092",
            "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 Jan 10, 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.