Medicina Urbana West Vernor PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101017883 Issued in MI

Legal business name

MEDICINA URBANA WEST VERNOR PLLC

Practice address

5700 W Vernor Hwy
Detroit, MI 48209

Phone

(313) 586-3066

Fax

(313) 586-3165

NPI assigned

Nov 13, 2017

Last updated

May 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Ryan Beard, DO

Title

Member

Phone

(313) 281-1362

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1740793777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092158",
            "telephone_number": "313-586-7481",
            "fax_number": "313-899-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48209",
            "telephone_number": "313-586-3066",
            "fax_number": "313-586-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINA URBANA WEST VERNOR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "313-281-1362",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101017883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Services Group PLC
• Medical Visiting Physicians PLLC
• Medicalmobileunlimitedllc
• Medicina Scarlett Express LLC
• Medicina Scarlett LLC
• Medico Pharmacy LLC
• Medicover Diagnostics Inc
• Medicover Diagnostics Inc
• Medicover Diagnostics Inc
• Mediki Senior Care LLC

• General Practice Physician in Detroit, MI
• Providers in Detroit, 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 15, 2018; 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.