NPIMap

Organization Active NPI

Detroit Medical Center

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1679732085
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L1127555 Issued in MI
Legal business name
DETROIT MEDICAL CENTER
Practice address
4201 St Antoine
Detroit, MI 48201
Phone
(313) 745-3862
NPI assigned
Jun 2, 2008
Last updated
Jun 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Wilhelmine Wiese
Title
M.D
Phone
(313) 745-3862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L1127555 MI Primary

Addresses

Primary practice location

4201 St Antoine
Detroit, MI 48201

Mailing address

4201St Antoine
Detroit, MI 48201

National Provider Directory

National Provider Directory
Tax ID family
DMC University Laborato12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1679732085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201ST ANTOINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST ANTOINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "WILHELMINE",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "313-745-3862"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1127555",
            "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 Jun 2, 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.