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MACOMB PRIMARY CARE PC NPI 1073842241


NPI Information

NPI: 1073842241
Provider Name: MACOMB PRIMARY CARE PC

Doing Business As: REVOLUTION WELLNESS

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
51850 DEQUINDRE RD STE 2
SHELBY TOWNSHIP, MI
ZIP 48316
Phone: (586) 323-0301
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MACOMB PRIMARY CARE PC is an internal medicine in Shelby Township, 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. MACOMB PRIMARY CARE PC NPI is 1073842241. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Revolution Wellness.

The provider's business location address is:

51850 DEQUINDRE RD STE 2
SHELBY TOWNSHIP, MI
ZIP 48316-806
Phone: (586) 323-0301

The provider's authorized official is Chadi Mansour .
The authorized official title is Physician and has the following contact phone number (586) 323-0301.

The enumeration date for this NPI number is 12/16/2009 and was last updated on 9/17/2021.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine4301077635MICHIGANYes

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: 5/5/2024

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