Individual provider Active NPI

Robert Walker, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1942242185
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301041208 Issued in MI
Practice address
28411 Northwestern Hwy
Suite 1050
Southfield, MI 48034-5544
Phone
(248) 354-4709
Fax
(248) 354-4807
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301041208 MI Primary

Addresses

Primary practice location

28411 Northwestern Hwy
Suite 1050
Southfield, MI 48034-5544

Mailing address

PO Box 674147
Detroit, MI 48267-4147
Phone (248) 354-4709

Other identifiers 5

IdentifierTypeStateIssuer
1346398971OtherMIGROUP NPI
207R00000XOtherMITAXONOMY
2704105MedicaidMI
110F336360OtherMIBCBSM
4301041208OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000389 MI Practitioner - Internal Medicine 4789609702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301041208MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Academic Internal Medicine Specialists PLLC Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
John Haapaniemi& Barry Lesser PTR,Haapaniemi Lesser Associated PastSince Oct 29, 2023 Accepting new patients
Grace University Medical Group Internal Medicine Past Accepting new patients
Macomb Internists PC Internal Medicine Past Accepting new patients

Locations

6071 W Outer Dr
Ste 7
Detroit, MI 48235
Phone (313) 966-3300

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

27209 Lahser Rd
Ste 120
Southfield, MI 48034
Phone (248) 358-4892

28411 Northwestern Hwy
Ste 1050
Southfield, MI 48034
Phone (248) 354-4709

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1942242185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674147",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482674147",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28411 NORTHWESTERN HWY",
            "address_2": "SUITE 1050",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345544",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1346398971",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "207R00000X",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2704105",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "110F336360",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301041208",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.