Active NPI
Dr Enos Marcus Humbles D.O. LLC
- General Practice Physician
- Redford, MI
National Provider Identifier
1891935656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5101011838
- Legal business name
- DR ENOS MARCUS HUMBLES D.O. LLC
- Practice address
- 23405 Plymouth Rd
Redford, MI 48239-1433 - Phone
- (313) 535-7880
- Fax
- (313) 535-8388
- NPI assigned
- Mar 5, 2009
- Organization subpart
- Yes
- Parent organization
- REDFORD URGENT CARE MEDICAL CLINIC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Enos Marcus Humbles, D.O.
- Title
- Owner/Medical Director
- Phone
- (313) 535-7880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 5101011838 | MI | Primary |
Addresses
Primary practice location
23405 Plymouth Rd
Redford, MI 48239-1433
Mailing address
23405 Plymouth Rd
Redford, MI 48239-1433
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114506064 | Medicaid | MI | |
| 1891935656 | Other | MI | GROUP NPI NUMBER |
| 1902850472 | Other | NPI | |
| 5101011838 | Other | MI | STATE OF MICHIGAN |
Other names 1
- Redford Urgent Care Medical Center
National Provider Directory
National Provider Directory- Part of
- Dr Enos Marcus Humbles LLC
Locations
23405 Plymouth Rd
Redford, MI 48239
Phone (313) 535-7880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1252627200000",
"number": "1891935656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23405 PLYMOUTH RD",
"city": "REDFORD",
"state": "MI",
"postal_code": "482391433",
"fax_number": "313-535-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23405 PLYMOUTH RD",
"city": "REDFORD",
"state": "MI",
"postal_code": "482391433",
"telephone_number": "313-535-7880",
"fax_number": "313-535-8388"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR ENOS MARCUS HUMBLES D.O. LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "REDFORD URGENT CARE MEDICAL CLINIC",
"enumeration_date": "2009-03-05",
"last_updated": "2009-09-11",
"status": "A",
"authorized_official_last_name": "HUMBLES",
"authorized_official_first_name": "ENOS",
"authorized_official_middle_name": "MARCUS",
"authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
"authorized_official_telephone_number": "313-535-7880",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": "MI",
"license": "5101011838",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114506064",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI NUMBER",
"identifier": "1891935656",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1902850472",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN",
"identifier": "5101011838",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Redford Urgent Care Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.