Image Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMAGE MEDICAL PC

Practice address

28479 7 Mile Rd
Livonia, MI 48152-3501

Phone

(248) 442-9320

Fax

(248) 442-8840

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Derrick Williamson, DO

Title

Physician

Phone

(248) 442-9320

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710008511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28479 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523501",
            "telephone_number": "248-442-9320",
            "fax_number": "248-442-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28479 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523501",
            "telephone_number": "248-442-9320",
            "fax_number": "248-442-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "248-442-9320",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.