Active NPI
David Robert Gendernalik, M.D.
- Psychiatry Physician
- Southfield, MI
National Provider Identifier
1598041949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301033160
- Practice address
- 29260 Franklin Rd
Suite 121
Southfield, MI 48034-1161 - Phone
- (248) 355-4300
- Fax
- (248) 355-4393
- NPI assigned
- Oct 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301033160 | MI | Primary |
Addresses
Primary practice location
29260 Franklin Rd
Suite 121
Southfield, MI 48034-1161
Mailing address
5096 Bayside Dr
Troy, MI 48098-2702
Phone (248) 641-8717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1598041949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5096 BAYSIDE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480982702",
"telephone_number": "248-641-8717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29260 FRANKLIN RD",
"address_2": "SUITE 121",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341161",
"telephone_number": "248-355-4300",
"fax_number": "248-355-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENDERNALIK",
"first_name": "DAVID",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301033160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.