GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC – NPI #1295939296
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC is a provider located in SOUTHFIELD, MI. NPPES has assigned the NPI number 1295939296 to GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC on June 13, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 17 years ago on May 29, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC below.

NPI Profile for
GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC

NPI Number
1295939296
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC
Primary location
23999 NORTHWESTERN HWY
SUITE 110
SOUTHFIELD, MI 48075-2578
Phone: (248) 223-1500 Fax: (248) 223-9600
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PAUL PETRE
OWNER
Phone: (248) 223-1500
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.