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COUNTRY CREEK FAMILY PHYSICIANS NPI 1104889773


NPI Information

NPI: 1104889773
Provider Name: COUNTRY CREEK FAMILY PHYSICIANS
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0371327

Address:
4986 ADAMS RD
STE A
ROCHESTER, MI
ZIP 48306
Phone: (248) 475-4301
Get Directions

COUNTRY CREEK FAMILY PHYSICIANS is a family medicine in Rochester, MI. The provider is 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. COUNTRY CREEK FAMILY PHYSICIANS NPI is 1104889773. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4986 ADAMS RD
STE A
ROCHESTER, MI
ZIP 48306-416
Phone: (248) 475-4301
Fax: (248) 475-4305

The provider's authorized official is Al Juocys .
The authorized official title is Physician and has the following contact phone number (248) 475-4301.

The CLIA number assigned to this NPI record is 23D0371327 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2006 and was last updated on 3/11/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2363A00000XPhysician AssistantNo
3207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10F32698OTHERBCBS
20P22250MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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.