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MARY E PETTY MD PC
NPI 1710928544
Family Medicine in Southgate, MI

Active since June 10, 2006
3 HERITAGE DR, SUITE 1, SOUTHGATE, MI 48195(734) 283-3222(734) 283-4006 Get Directions Write a Review

NPPES record last updated: June 30, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary E Petty Md Pc NPPES

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

MARY E PETTY MD PC (NPI 1710928544) is a healthcare organization registered as a family medicine in Southgate, Michigan and active in the NPI registry since June 2006. The organization lists Mary Evelyn Petty, Physician, as its authorized official.

NPPES Registry Identity

NPI1710928544
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMARY E PETTY MD PC
Location Address3 HERITAGE DR, SUITE 1Southgate, MI 48195-3000
Mailing AddressPo Box 193Rockwood, MI 48173-0193 · (734) 283-3222 · Fax (734) 283-4006
Phone(734) 283-3222
Fax(734) 283-4006
Organization SubpartNo
Authorized OfficialMary Evelyn PettyPhysician · (734) 283-3222
Enumeration DateJune 10, 2006
Last NPPES UpdateJune 30, 2015
✔ NPI 1710928544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · MP058113
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.
3 HERITAGE DR, Southgate, MI 48195
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Other Identifiers 7

OtherMP058113Bcbs
Medicaid4157286MI
Medicaid4887167MI
Other7503086MI · Aetna
Medicare UPING44050MI
Medicare PIN0P32340
Other102435MI · Great Lakes

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 SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

DR. MICHAEL NESHEWAT M.D.
Internal Medicine
3 HERITAGE DR, SUITE 1
SOUTHGATE, MI 48195
Wayne County (734) 283-3222
DR. MARY E PETTY-DUDLEY M.D.
Internal Medicine
3 HERITAGE DR, SUITE 1
SOUTHGATE, MI 48195
Wayne County (734) 283-3222

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 Mary E Petty MD PC's NPI number?

The NPI number for Mary E Petty MD PC is 1710928544. It was assigned to this organization in the NPPES registry on June 10, 2006.

Where is Mary E Petty MD PC located?

Mary E Petty MD PC is located at 3 Heritage Dr Suite 1, Southgate, MI 48195. The listed phone number is (734) 283-3222.

What is Mary E Petty MD PC'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 Mary E Petty MD PC was last updated on June 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.