Organization Active NPI

Suburban Healthcare Organization PLLC

  • Adult Medicine Physician
  • Trenton, MI
National Provider Identifier
1790193324
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
SUBURBAN HEALTHCARE ORGANIZATION PLLC
Practice address
1600 Kingsway CT
Lower Level
Trenton, MI 48183-1962
Phone
(734) 752-6281
Fax
(734) 752-6559
NPI assigned
Jul 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Dr. Irwin Marcus Lutwin, D.O.
Title
Owner
Phone
(734) 752-6281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

1600 Kingsway CT
Lower Level
Trenton, MI 48183-1962

Mailing address

1600 Kingsway CT
Lower Level
Trenton, MI 48183-1962
Phone (734) 752-6281

Other identifiers 1

IdentifierTypeStateIssuer
1013979244OtherMIBCBS

National Provider Directory

National Provider Directory

Locations

1600 Kingsway Ct
Lowr
Trenton, MI 48183
Phone (734) 752-6281

1600 Kingsway Ct
Trenton, MI 48183
Phone (734) 675-9422

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1790193324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 KINGSWAY CT",
            "address_2": "LOWER LEVEL",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481831962",
            "telephone_number": "734-752-6281",
            "fax_number": "734-752-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 KINGSWAY CT",
            "address_2": "LOWER LEVEL",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481831962",
            "telephone_number": "734-752-6281",
            "fax_number": "734-752-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN HEALTHCARE ORGANIZATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "LUTWIN",
        "authorized_official_first_name": "IRWIN",
        "authorized_official_middle_name": "MARCUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-752-6281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1013979244",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.