GRACE UNIVERSITY MEDICAL GROUP NPI 1447215538

Internal Medicine in Detroit, MI

About GRACE UNIVERSITY MEDICAL GROUP

Grace University Medical Group is a provider in Detroit, MI. The NPI number assigned to this provider is 1447215538. The practitioner's primary taxonomy code is Internal Medicine (207R00000X). The provider is registered as an organization and their NPI record was last updated 11 years ago. Grace University Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization.

NPI

1447215538

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameGRACE UNIVERSITY MEDICAL GROUP
Provider Location Address6071 W OUTER DR DEPT OF MEDICINE 4TH FLOOR DETROIT, MI 48235 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 321061 DETROIT, MI 48232 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-20-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-19-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code207R00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

GRACE UNIVERSITY MEDICAL GROUP
6071 W OUTER DR
DEPT OF MEDICINE 4TH FLOOR
DETROIT, MI
ZIP 48235
Phone: (313) 966-4946

Get Directions

Mailing Address

GRACE UNIVERSITY MEDICAL GROUP
PO BOX 321061
DETROIT, MI
ZIP 48232
Phone: (248) 543-8070

Authorized Official

Authorized Official Name KENNETH BERGSMAN MD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleMANAGER
Authorized Official Phone(313) 966-4946

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

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology4301028293MINo

Taxonomy Description: an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0F37295MEDICARE PIN (08)MI
0Q26497MEDICARE PIN (08)MI

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003873076 ZAKLINA DENDOOVEN CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1003877424DR. MATTHEW J GRIFFIN M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1174590384MR. DAVID CHRISTOPHER MILLER PA-C
Individual
Physician Assistant6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3250
1205836806SELECT SPECIALTY HOSPITAL - NORTHWEST DETROIT INC
Organization
Long Term Care Hospital6071 W OUTER DR 7TH FLOOR
DETROIT, MI 48235
(313) 966-4797
1346201399 BEVELY ROBERTS CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1346216744 THOMAS BAKER CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1427018225DR. MELISSA A BARTON M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1447219670DR. REGINA T NOACK M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1487623617DR. MARC-ANTHONY Q VELILLA M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1497714265DR. CLAUDIA I WHITAKER M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1528022118SINAI HOSPITAL OF GREATER DETROIT
Organization
Psychiatric Unit6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1528037785DR. ALLISON LEVI M.D.
Individual
Emergency Medicine (Emergency Medical Services)6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1558320598DR. ANN MARIE GARRITANO M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1588623763DR. RAJAN U POPAT M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3000
1760442586DR. MARK W BRAUTIGAN M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1780645630SINAI HOSPITAL OF GREATER DETROIT
Organization
General Acute Care Hospital6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1790746113DR. MARC S ROSENTHAL D.O.
Individual
Emergency Medicine6071 W OUTER DR SINAI-GRACE HOSPITAL
DETROIT, MI 48235
(313) 966-1785
1801853767SINAI HOSPITAL OF GREATER DETROIT
Organization
Rehabilitation Unit6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1871553404DR. HAROLD S DERSTINE M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1902866734DR. REGINALD J EADIE M.D.
Individual
Emergency Medicine (Emergency Medical Services)6071 W OUTER DR
DETROIT, MI 48235
(313) 745-2780
Previous NPI
1447215520
Next NPI
1447215546