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VANDYKE MEDICAL CLINIC MANAGEMENT CORP
NPI 1174632087
Clinic/Center - Health Service in Detroit, MI

Active since August 30, 2006
19431 VAN DYKE ST, DETROIT, MI 48234(313) 893-2010(313) 893-3308 Get Directions Write a Review

NPPES record last updated: December 1, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vandyke Medical Clinic Management Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VANDYKE MEDICAL CLINIC MANAGEMENT CORP (NPI 1174632087) is a healthcare organization registered as a health service in Detroit, Michigan and active in the NPI registry since August 2006. The organization lists Ernest A Mullen, President, as its authorized official.

NPPES Registry Identity

NPI1174632087
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameVANDYKE MEDICAL CLINIC MANAGEMENT CORP
Location Address19431 VAN DYKE STDetroit, MI 48234-3323
Mailing Address19431 Van Dyke StDetroit, MI 48234-3323 · (313) 893-2010 · Fax (313) 893-3308
Phone(313) 893-2010
Fax(313) 893-3308
Organization SubpartNo
Authorized OfficialErnest A MullenPresident · (313) 893-2010
Enumeration DateAugust 30, 2006
Last NPPES UpdateDecember 1, 2015
✔ NPI 1174632087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in MI · 4301081357
19431 VAN DYKE ST, Detroit, MI 48234
Open in Google Maps ↗

Other Identifiers 2

Other080H249740MI · Blue Cross Group Pin
Medicaid4796189 TYPE 10MI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERNEST MULLEN MD PC
Clinic/Center
19431 VAN DYKE ST
DETROIT, MI 48234
Wayne County (734) 306-2446

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vandyke Medical Clinic Management Corp's NPI number?

The NPI number for Vandyke Medical Clinic Management Corp is 1174632087. It was assigned to this organization in the NPPES registry on August 30, 2006.

Where is Vandyke Medical Clinic Management Corp located?

Vandyke Medical Clinic Management Corp is located at 19431 Van Dyke St, Detroit, MI 48234. The listed phone number is (313) 893-2010.

What is Vandyke Medical Clinic Management Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Vandyke Medical Clinic Management Corp was last updated on December 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.