Angela Bully M.D., P.L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301057665 Issued in MI

Legal business name

ANGELA BULLY M.D., P.L.L.C.

Practice address

4160 John R St
Suite 804
Detroit, MI 48201-2020

Phone

(313) 833-1271

Fax

(313) 833-1273

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Angela Bully, M.D.NPI 1841257029

Title

Physician Owner

Phone

(313) 833-1271

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

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

• Angela Bully, M.D.

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1841257029
  Medicare reassignment NPD Authorized official
• Tammie Lee Bully, M.D.

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1366536088
  Medicare reassignment NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1922215201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 804",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-833-1271",
            "fax_number": "313-833-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 804",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-833-1271",
            "fax_number": "313-833-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA BULLY M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "BULLY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "313-833-1271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301057665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104357008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1841257029",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE #",
            "identifier": "4301084811",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P61277",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1108235671",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1366536088",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE #",
            "identifier": "4301057665",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Eyes Staffing
• Angel Patient Inc. (Angel Patience)
• Angel Seekers Home Care Agency
• Teresa Angel-Morones
• Lauren Elizabeth Angel, M.A.
• Angela L. Harris, M.D., P.C.
• Angela's House Residential Care, LLC
• Jerky Guevara Angeles, BSN RN
• Angelhands Homecare
• Angelic Angels Home Healthcare

• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.