NPIMap

Organization Active NPI

Praveen Modi, M.D., P.C.

  • Internal Medicine Physician
  • Plymouth, MI
National Provider Identifier
1922345107
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PM069773 Issued in MI
Legal business name
PRAVEEN MODI, M.D., P.C.
Practice address
990 W Ann Arbor TRL
Suite 102
Plymouth, MI 48170-6204
Phone
(734) 414-1088
Fax
(734) 414-1095
NPI assigned
Jan 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Donna Billand
Title
Office Manager
Phone
(734) 414-1023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X PM069773 MI Primary

Addresses

Primary practice location

990 W Ann Arbor TRL
Suite 102
Plymouth, MI 48170-6204

Mailing address

990 W Ann Arbor TRL
Plymouth, MI 48170-6204
Phone (734) 414-1088

National Provider Directory

National Provider Directory
Tax ID family
Praveen Modi MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1922345107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1088",
            "fax_number": "734-414-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "address_2": "SUITE 102",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1088",
            "fax_number": "734-414-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVEEN MODI, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "BILLAND",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-414-1023"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "PM069773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.