Organization Active NPI

Guru Nanak Dev Clinic PLC

  • Psychiatry Physician
  • Romulus, MI
National Provider Identifier
1871220350
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GURU NANAK DEV CLINIC PLC
Practice address
9950 Wayne Rd
Romulus, MI 48174-3429
Phone
(734) 892-2712
Fax
(734) 892-2714
NPI assigned
Aug 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Ravinder SandhuNPI 1023435179
Title
Owner
Phone
(734) 377-8046

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

9950 Wayne Rd
Romulus, MI 48174-3429

Mailing address

9950 Wayne Rd
Romulus, MI 48174-3429
Phone (734) 892-2712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220826000905 MI Part B Supplier - Clinic/Group Practice 4981088812 Receives reassigned benefits from 1 practitioner
Practice locations: Romulus, MI

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": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1871220350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9950 WAYNE RD",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481743429",
            "telephone_number": "734-892-2712",
            "fax_number": "734-892-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 WAYNE RD",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481743429",
            "telephone_number": "734-892-2712",
            "fax_number": "734-892-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURU NANAK DEV CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "SANDHU",
        "authorized_official_first_name": "RAVINDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-377-8046"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romulus, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.