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MICHIGAN MEDICAL MALL
NPI 1194133686
Family Medicine in Detroit, MI

Active since July 28, 2014
17350 LIVERNOIS AVE, DETROIT, MI 48221(256) 262-9310 Get Directions Write a Review

NPPES record last updated: July 28, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michigan Medical Mall NPPES

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

MICHIGAN MEDICAL MALL (NPI 1194133686) is a healthcare organization registered as a family medicine in Detroit, Michigan and active in the NPI registry since July 2014. The organization lists Schara Davis, Owner/incorporator, as its authorized official.

NPPES Registry Identity

NPI1194133686
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMICHIGAN MEDICAL MALL
Location Address17350 LIVERNOIS AVEDetroit, MI 48221-2759
Mailing Address17350 Livernois AveDetroit, MI 48221-2759
Phone(256) 262-9310
Organization SubpartNo
Authorized OfficialSchara DavisOwner/incorporator · (256) 262-9310
Enumeration DateJuly 28, 2014
✔ NPI 1194133686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
17350 LIVERNOIS AVE, Detroit, MI 48221
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

JABREEIA MATTHEWS
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465
SHAIPRECE ROBERSON
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465
KATRINA BELIN
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465
TYRA HARPER
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 854-9569
PINK DIAMOND BEAUTY MALL DETROIT LLC
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465
PINK DIAMOND CROWN COLLECTION
Prosthetic/Orthotic Supplier
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465
CHRISTEN DANIELLE STOTT
Community Health Worker
17350 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (855) 683-7465

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 Michigan Medical Mall's NPI number?

The NPI number for Michigan Medical Mall is 1194133686. It was assigned to this organization in the NPPES registry on July 28, 2014.

Where is Michigan Medical Mall located?

Michigan Medical Mall is located at 17350 Livernois Ave, Detroit, MI 48221. The listed phone number is (256) 262-9310.

What is Michigan Medical Mall's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Michigan Medical Mall was last updated on July 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.