Macomb Primary Care, P.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MACOMB PRIMARY CARE, P.C.

Practice address

39915 Grand River Avenue
Suite # 750
Novi, MI 48375-2153

Phone

(248) 476-7775

Fax

(248) 987-4972

NPI assigned

Jun 10, 2015

Organization subpart

No

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

Authorized official

Name

Chadi H Mansour, M.D.

Title

Owner/President

Phone

(586) 323-0301

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1700267267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43393 SCHOENHERR ROAD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131959",
            "telephone_number": "586-323-0301",
            "fax_number": "586-323-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39915 GRAND RIVER AVENUE",
            "address_2": "SUITE # 750",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752153",
            "telephone_number": "248-476-7775",
            "fax_number": "248-987-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB PRIMARY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "CHADI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "586-323-0301",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Mack, DPT
• Brittany M Mackie
• Anna Macmillan
• Bridget Esther Macmillan
• Kelsey Susan Macneill
• Yamini Mada, DDS
• Akanksha Madan, LLPC
• Eva Ken'Yanna Madden, M.A.
• Luci Madden
• Allison Maddox

• Durable Medical Equipment & Medical Supplies in Novi, MI
• Providers in Novi, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.