NPIMap

Organization Active NPI

Waterford Medical Associates PC

  • Family Medicine Physician
  • Waterford, MI
National Provider Identifier
1831244912
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WATERFORD MEDICAL ASSOCIATES PC
Practice address
3560 Pontiac Lake Rd
Waterford, MI 48328-2337
Phone
(248) 674-2259
Fax
(248) 674-3356
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Authorized official

Name
Dr. Paul Martin Gold, DONPI 1093778037
Title
President
Phone
(248) 674-2259

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

3560 Pontiac Lake Rd
Waterford, MI 48328-2337

Mailing address

3560 Pontiac Lake Rd
Waterford, MI 48328-2337
Phone (248) 674-2259

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1831244912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282337",
            "telephone_number": "248-674-2259",
            "fax_number": "248-674-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282337",
            "telephone_number": "248-674-2259",
            "fax_number": "248-674-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFORD MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-674-2259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.