Organization Active NPI

Samir Setouhi MD PC

  • Specialist
  • Dearborn, MI
National Provider Identifier
1760669303
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301044804 Issued in MI
Legal business name
SAMIR SETOUHI MD PC
Practice address
7145 Appoline St
Neurology, Headache & Pain Management
Dearborn, MI 48126-1991
Phone
(313) 581-0003
Fax
(313) 581-3399
NPI assigned
Jan 25, 2008
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Dr. Samir Sotouhi, M.D., B.C.NPI 1659305605
Title
Owner
Phone
(313) 581-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301044804 MI Primary

Addresses

Primary practice location

7145 Appoline St
Neurology, Headache & Pain Management
Dearborn, MI 48126-1991

Mailing address

7145 Appoline St
Neurology, Headache & Pain Management
Dearborn, MI 48126-1991
Phone (313) 581-0003

Other identifiers 2

IdentifierTypeStateIssuer
4880228MedicaidMI
1308255022OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060404000539 MI Part B Supplier - Clinic/Group Practice 2769490655 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

20225 Ann Arbor Trl
Ste 1
Dearborn Heights, MI 48127
Phone (313) 581-0003

20225 Ann Arbor Trl
Ste 100
Dearborn Heights, MI 48127
Phone (313) 581-0003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1760669303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 APPOLINE ST",
            "address_2": "NEUROLOGY, HEADACHE & PAIN MANAGEMENT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261991",
            "telephone_number": "313-581-0003",
            "fax_number": "313-581-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7145 APPOLINE ST",
            "address_2": "NEUROLOGY, HEADACHE & PAIN MANAGEMENT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261991",
            "telephone_number": "313-581-0003",
            "fax_number": "313-581-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMIR SETOUHI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "SOTOUHI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-581-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., B.C."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301044804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4880228",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1308255022",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.