Brenda Ubom, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101007548 Issued in MI

Practice address

3001 Miller Rd
Dearborn, MI 48120-1458

Phone

(313) 323-0045

Fax

(313) 845-4626

NPI assigned

May 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1689840472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24410 SANTA BARBARA ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756813",
            "telephone_number": "248-559-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 MILLER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201458",
            "telephone_number": "313-323-0045",
            "fax_number": "313-845-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBOM",
        "first_name": "BRENDA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101007548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.