NPIMap

Organization Active NPI

Medical Services of Detroit PC

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1821296815
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301086699 Issued in MI
Legal business name
MEDICAL SERVICES OF DETROIT PC
Practice address
24261 Greenfield Rd
Suite a
Southfield, MI 48075-3117
Phone
(248) 569-9523
Fax
(248) 569-9529
NPI assigned
Jul 11, 2007
Organization subpart
Yes
Parent organization
MEDICAL SERVICES OF DETROIT PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Virgil Luz
Title
Financial Controller
Phone
(248) 569-9523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 4301086699 MI Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301041657 MI

Addresses

Primary practice location

24261 Greenfield Rd
Suite a
Southfield, MI 48075-3117

Mailing address

24261 Greenfield Rd
Suite a
Southfield, MI 48075-3117
Phone (248) 569-9523

Other identifiers 1

IdentifierTypeStateIssuer
0F33548OtherMIBCBSM PIN

Other names 1

  • Greenfield Medical Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical SVCS of Detroit PC3 organizations share this tax ID, including this one
Part of
Medical SVCS of Detroit PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24261 Greenfield Rd
Ste A
Southfield, MI 48075
Phone (248) 569-8151

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1821296815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24261 GREENFIELD RD",
            "address_2": "SUITE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753117",
            "telephone_number": "248-569-9523",
            "fax_number": "248-569-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24261 GREENFIELD RD",
            "address_2": "SUITE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753117",
            "telephone_number": "248-569-9523",
            "fax_number": "248-569-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SERVICES OF DETROIT PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL SERVICES OF DETROIT PC",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "LUZ",
        "authorized_official_first_name": "VIRGIL",
        "authorized_official_title_or_position": "FINANCIAL CONTROLLER",
        "authorized_official_telephone_number": "248-569-9523"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301086699",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0F33548",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenfield Medical Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.