NPIMap

Organization Active NPI

Az Medical Services Management LLC

  • General Practice Physician
  • Detroit, MI
National Provider Identifier
1669788121
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AZ MEDICAL SERVICES MANAGEMENT LLC
Practice address
7405 Puritan St
Detroit, MI 48238-1207
Phone
(313) 862-8050
NPI assigned
Aug 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Authorized official

Name
Mr. Jerry Omar
Title
Vice President
Phone
(313) 862-8050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

7405 Puritan St
Detroit, MI 48238-1207

Mailing address

PO Box 40420
Redford, MI 48240-0420

National Provider Directory

National Provider Directory

Locations

25121 Ford Rd
Dearborn, MI 48128
Phone (248) 834-4555

7405 Puritan St
Detroit, MI 48238
Phone (313) 862-8050

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1669788121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40420",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482400420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 PURITAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381207",
            "telephone_number": "313-862-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ MEDICAL SERVICES MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "313-862-8050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "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 Aug 23, 2010; 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.