DOWNRIVER CLINIC PC NPI 1205073285

NPI Information

  • NPI: 1205073285
  • Provider Name: DOWNRIVER CLINIC PC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 23D1093973
  • Address: 8944 MACOMB ST
    GROSSE ILE, MI
    ZIP 48138
  • Phone: (734) 675-0705

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NPI Details

DOWNRIVER CLINIC PC is an internal medicine in Grosse Ile, 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. DOWNRIVER CLINIC PC NPI is 1205073285. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8944 MACOMB ST
GROSSE ILE, MI
ZIP 48138-089
Phone: (734) 675-0705
Fax: (734) 675-0747

The provider's authorized official is Mounir Khaled .
The authorized official title is Owner Medical Director Physician and has the following contact phone number (734) 675-0705.

The CLIA number assigned to this NPI record is 23D1093973 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/14/2009 and was last updated on 7/15/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine4301091157MICHIGANYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1259686OTHERMICHIGANDEPT OF LABOR STATE
2614738100OTHERMICHIGANDEPT OF LABOR
3110H242960OTHERMICHIGANBCBS GROUP
4DO7341OTHERMICHIGANRAILROAD MEDICARE
5174382OTHERMICHIGANGREAT LAKES
682028050OTHERMICHIGANPROCARE
71205073285MEDICAIDMICHIGAN
8MI1438MEDICARE PINMICHIGAN

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: 11/21/2025

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