Birmingham Medical PLLC

Organization Active NPI Family Medicine Physician · Birmingham, MI

NPI 1982806782 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1982806782
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BIRMINGHAM MEDICAL PLLC
Practice address
180 E Brown St
Birmingham, MI 48009-6237
Phone
(248) 645-1000
NPI assigned
Jun 4, 2007
Organization subpart
No

Authorized official

Name
Lyle Scott Grant, MD
Title
Owner
Phone
(248) 645-1000

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110224000860 MI Part B Supplier - Clinic/Group Practice 3870774730 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

Locations

180 E Brown St
Birmingham, MI 48009
Phone (248) 593-9999

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

180 E Brown St
Birmingham, MI 48009-6237

Mailing address

180 E Brown St
Birmingham, MI 48009-6237
Phone (248) 645-1000

Other providers in Birmingham, MI

All providers in Birmingham, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.