GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC
NPI 1295939296
General Practice in Southfield, MI

Q: What is Great Lakes Physicians Of Southfield,pllc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since June 13, 2007

23999 NORTHWESTERN HWY, SUITE 110, SOUTHFIELD, MI 48075(248) 223-1500(248) 223-9600 Get Directions Write a Review

NPPES record last updated: May 29, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Physicians Of Southfield,pllc NPPES

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

GREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC (NPI 1295939296) is a healthcare organization registered as a general practice in Southfield, Michigan and active in the NPI registry since June 2007. The organization lists Paul M Petre, Owner, as its authorized official.

NPPES Registry Identity

NPI1295939296

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameGREAT LAKES PHYSICIANS OF SOUTHFIELD,PLLC

Location Address23999 NORTHWESTERN HWY, SUITE 110Southfield, MI 48075-2578

Mailing Address23999 Northwestern Hwy, Suite 110Southfield, MI 48075-2578 · (248) 223-1500 · Fax (248) 223-9600

Phone(248) 223-1500

Fax(248) 223-9600

Organization SubpartNo

Authorized OfficialPaul M PetreOwner · (248) 223-1500

Enumeration DateJune 13, 2007

Last NPPES UpdateMay 29, 2009

✔ NPI 1295939296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

23999 NORTHWESTERN HWY, Southfield, MI 48075

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Other Identifiers 1

Medicare PIN0P43460

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 20

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

ARK HEALTH LLC

General Practice

23999 NORTHWESTERN HWY
SOUTHFIELD, MI 48075

Oakland County (248) 924-1429

ASHTIAQ KHOKHAR

Physical Therapist

23999 NORTHWESTERN HWY
SOUTHFIELD, MI 48075

Oakland County (248) 304-1100

BENEVOLENT HEALTH CARE CLINIC

Specialist

23999 NORTHWESTERN HWY, STE 114
SOUTHFIELD, MI 48075

Oakland County (248) 910-7972

MR. JAMES BENJIMAN BURDETTE III PA-C

Physician Assistant (Medical)

23999 NORTHWESTERN HWY, SUITE # 110
SOUTHFIELD, MI 48075

Oakland County (248) 223-1500

RACHEL KIMBERLY STABEL R.N.

Registered Nurse

23999 NORTHWESTERN HWY
SOUTHFIELD, MI 48075

Oakland County (248) 569-4778

ADA HOMES, INC.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

23999 NORTHWESTERN HWY, SUITE 200
SOUTHFIELD, MI 48075

Oakland County (248) 557-2544

NORTHWESTERN REHABILITATION SERVICES. LLC

Clinic/Center (Physical Therapy)

23999 NORTHWESTERN HWY, SUITE 105
SOUTHFIELD, MI 48075

Oakland County (248) 352-4984

QUALITY FOOT & ANKLE CLINIC

Durable Medical Equipment & Medical Supplies

23999 NORTHWESTERN HWY, SUITE 220
SOUTHFIELD, MI 48075

Oakland County (248) 996-6465

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 Great Lakes Physicians Of Southfield,pllc's NPI number?

The NPI number for Great Lakes Physicians Of Southfield,pllc is 1295939296. It was assigned to this organization in the NPPES registry on June 13, 2007.

Where is Great Lakes Physicians Of Southfield,pllc located?

Great Lakes Physicians Of Southfield,pllc is located at 23999 Northwestern Hwy Suite 110, Southfield, MI 48075. The listed phone number is (248) 223-1500.

What is Great Lakes Physicians Of Southfield,pllc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Physicians Of Southfield,pllc was last updated on May 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.