Organization Active NPI

Mahir D Elder MD PC

  • Cardiovascular Disease Physician
  • Detroit, MI
National Provider Identifier
1992032007
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME073824 Issued in MI
Legal business name
MAHIR D ELDER MD PC
Practice address
4160 John R St Ste 510
Detroit, MI 48201-2021
Phone
(313) 999-2222
Fax
(313) 993-2563
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Dr. Mahir D Elder, M.D.
Title
President
Phone
(313) 993-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X ME073824 MI Primary

Addresses

Primary practice location

4160 John R St Ste 510
Detroit, MI 48201-2021

Mailing address

4160 John R St Ste 510
Detroit, MI 48201-2021
Phone (313) 993-7777

Other identifiers 2

IdentifierTypeStateIssuer
105174942MedicaidMI
I60238OtherMIUPIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1992032007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 510",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012021",
            "telephone_number": "313-993-7777",
            "fax_number": "313-993-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 510",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012021",
            "telephone_number": "313-999-2222",
            "fax_number": "313-993-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHIR D ELDER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "MAHIR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-993-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "ME073824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105174942",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "I60238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.