MAECENAS HEALTH SYSTEMS PC - NPI NUMBER 1003155607

Summary

Provider Name: MAECENAS HEALTH SYSTEMS PC

NPI Number: 1003155607

Clasification: Internal Medicine (207R00000X)

Address:
26677 W 12 MILE RD
SOUTHFIELD, MI
ZIP 48034

Phone Number: (248) 358-6995



Detailed Information

MAECENAS HEALTH SYSTEMS PC is an internist in Southfield, MI. The provider is a 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. The assigned NPI number for this provider is 1003155607 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

26677 W 12 MILE RD
SOUTHFIELD, MI
ZIP 48034-514
Phone: (248) 358-6995

The provider's authorized official is Solomon Chukwuemeka Awusah .
The authorized official title is President and has the following contact phone number (248) 790-5808.

The enumeration date for this NPI number is 2/4/2013 and was last updated on 2/15/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207R00000X Internal Medicine 4301093171 MI Yes

NPI Record

No. Field Name Field Value
1 NPI 1003155607
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name MAECENAS HEALTH SYSTEMS PC
5 Provider First Line Business Practice Location Address 26677 W 12 MILE RD
6 Provider Business Practice Location Address City Name SOUTHFIELD
7 Provider Business Practice Location Address State Name MI
8 Provider Business Practice Location Address Postal Code 480341514
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 2483586995
11 Provider Enumeration Date 2/4/2013
12 Last Update Date 2/15/2013
13 Authorized Official Last Name AWUSAH
14 Authorized Official First Name SOLOMON
15 Authorized Official Middle Name CHUKWUEMEKA
16 Authorized Official Title or Position PRESIDENT
17 Authorized Official Telephone Number 2487905808
18 Healthcare Provider Taxonomy Code 1 207R00000X
19 Provider License Number 1 4301093171
20 Provider License Number State Code 1 MI
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Organization Subpart N
23 Authorized Official Name Prefix Text DR.
24 Authorized Official Credential Text MD
25 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.