Dedicated Physicians Group of Michigan, PLLC

Organization Active NPI Internal Medicine Physician · Miami Gardens, FL

NPI 1992392393 · NPPES record last updated Oct 31, 2024

Key facts

NPI
1992392393
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
DEDICATED PHYSICIANS GROUP OF MICHIGAN, PLLC
Practice address
1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone
(305) 628-6117
NPI assigned
Dec 31, 2020
Organization subpart
No

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 831-4722

Corporate family (same tax ID) 6

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

Practitioners 44

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

View all 44

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210201000062 MI Part B Supplier - Clinic/Group Practice 1153735287 Receives reassigned benefits from 43 practitioners
Practice locations: Warren, MI; Southfield, MI; Eastpointe, MI; Detroit, MI

National Provider Directory

Tax ID family
Dedicated Physicians Group of Michigan PLLC (7 organizations share this tax ID)

Locations

6150 Cadieux Rd
Detroit, MI 48224
Phone (313) 398-2800

21811 Kelly Rd
Eastpointe, MI 48021
Phone (586) 649-3388

21832 W 11 Mile Rd
Southfield, MI 48076
Phone (248) 375-4040

1921 E 8 Mile Rd
Warren, MI 48091
Phone (586) 755-3046

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

1395 NW 167TH St
Miami Gardens, FL 33169-5710

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710

Other names

  • Dedicated Senior Medical Center Doing business as

Other providers in Miami Gardens, FL

All providers in Miami Gardens, FL · Internal Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.