Great Lakes Family Medical Center PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GREAT LAKES FAMILY MEDICAL CENTER PLLC

Practice address

4420 E Davison St
Detroit, MI 48212-1744

Phone

(313) 369-1500

Fax

(313) 369-1205

NPI assigned

Feb 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Arunima Shirvastava, M.D.

Title

Owner

Phone

(734) 266-2780

Specialties & licenses 1

Addresses

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.

• Arunima Shrivastava, M.D.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1770554164
  NPD

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598737769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28801 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502385",
            "telephone_number": "734-266-2780",
            "fax_number": "734-466-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 E DAVISON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121744",
            "telephone_number": "313-369-1500",
            "fax_number": "313-369-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FAMILY MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIRVASTAVA",
        "authorized_official_first_name": "ARUNIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-266-2780",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Grazes, APRN, NNP-DC
• Great American Rehabilitation and Physical Therapy Center, Inc.
• Great Futures Family Services Inc
• Great Lakes Accident Service LTD.
• Great Lakes Dialysis, L.L.C. (Dialysis Care Center Great Lakes East)
• Great Lakes Family Medical Center PLLC
• Great Lakes Family Services
• Great Lakes Medical Supplies Inc
• Great Lakes Property & Investment, Inc (Great Lakes Property Community Outreach)
• Great Scott Homes Inc

• 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 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.