Great Lakes Family Medical Center PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GREAT LAKES FAMILY MEDICAL CENTER PLLC

Practice address

4420 E Davison St
Detroit, MI 48212-1744

Phone

(313) 369-1500

Fax

(313) 369-1205

NPI assigned

Jan 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Amitabh Paharia, MD

Title

Owner

Phone

(313) 369-1500

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1982881025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 E DAVISON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121744",
            "telephone_number": "313-369-1500",
            "fax_number": "313-369-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 E DAVISON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121744",
            "telephone_number": "313-369-1500",
            "fax_number": "313-369-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FAMILY MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "PAHARIA",
        "authorized_official_first_name": "AMITABH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-369-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great American Rehabilitation and Physical Therapy Center, Inc.
• Great Futures Family Services Inc
• Great Lakes Accident Service LTD.
• Great Lakes Dialysis, L.L.C.
• Great Lakes Family Medical Center PLLC
• Great Lakes Family Services
• Great Lakes Medical Supplies Inc
• Great Lakes Property & Investment, Inc
• Great Scott Homes Inc
• Great Scott Homes Inc.

• Primary Care Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.