PERRY MLK MEDICAL CENTER P.C.
NPI 1407942394
General Practice in Pontiac, MI

Active since October 05, 2006CLIA 23D0956754 · Waiver
673 MARTIN LUTHER KING JR BLVD N, PONTIAC, MI 48342(248) 338-2793 Get Directions Write a Review

NPPES record last updated: October 26, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Perry Mlk Medical Center P.c. NPPES

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

PERRY MLK MEDICAL CENTER P.C. (NPI 1407942394) is a healthcare organization registered as a general practice in Pontiac, Michigan and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through February 3, 2027 and lists Bryan K Swilley, President, as its authorized official.

NPPES Registry Identity

NPI1407942394
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePERRY MLK MEDICAL CENTER P.C.
Location Address673 MARTIN LUTHER KING JR BLVD NPontiac, MI 48342-1627
Mailing Address673 Martin Luther King Jr Blvd NPontiac, MI 48342-1627 · (248) 338-2793
Organization SubpartNo
Authorized OfficialBryan K SwilleyPresident · (248) 338-2793
Enumeration DateOctober 5, 2006
Last NPPES UpdateOctober 26, 2010
NPI 1407942394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License Licensed in MI · BS010362
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
673 MARTIN LUTHER KING JR BLVD N, Pontiac, MI 48342

Other Identifiers 6

Other132616MI · Care Choices
Other000000001401MI · Cape Health Plan
Medicare ID-Type UnspecifiedON50370001MI
Other0856308604MI · Bcbs Of Mi
Medicare UPINF24498MI
Medicaid114402195MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0956754

Perry Mlk Medical Center, PC · Pontiac, MI
Active · expires Feb 3, 2027
CLIA Number23D0956754
Laboratory TypePhysician Office
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorBryan Swilley Do
Laboratory Phone(248) 334-4961
Laboratory LocationPerry Mlk Medical Center, PC673 Martin Luther King Blvd North, Pontiac, MI 48342
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Clinic/Center (Methadone)
673 MARTIN LUTHER KING JR BLVD N
PONTIAC, MI 48342

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 Perry Mlk Medical Center P.C.'s NPI number?

The NPI number for Perry Mlk Medical Center P.C. is 1407942394. It was assigned to this organization in the NPPES registry on October 5, 2006.

Where is Perry Mlk Medical Center P.C. located?

Perry Mlk Medical Center P.C. is located at 673 Martin Luther King Jr Blvd N, Pontiac, MI 48342. The listed phone number is (248) 338-2793.

What is Perry Mlk Medical Center P.C.'s specialty?

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

Does Perry Mlk Medical Center P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0956754) is associated with this NPI, valid through February 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Perry Mlk Medical Center P.C. accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Perry Mlk Medical Center P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Perry Mlk Medical Center P.C. was last updated on October 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.