PROMED PRIMARY CARE PLLC NPI 1336808864

NPI Information

  • NPI: 1336808864
  • Provider Name: PROMED PRIMARY CARE PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 23D2245670
  • Address: 19041 E 12 MILE RD STE 103
    ROSEVILLE, MI
    ZIP 48066
  • Phone: (586) 252-9737

Map and Directions

Get Directions

NPI Details

PROMED PRIMARY CARE PLLC is a family medicine in Roseville, 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. PROMED PRIMARY CARE PLLC NPI is 1336808864. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

19041 E 12 MILE RD STE 103
ROSEVILLE, MI
ZIP 48066-609
Phone: (586) 252-9737
Fax: (586) 252-2909

The provider's authorized official is Manolis Kyriacou .
The authorized official title is Owner and has the following contact phone number (586) 252-9737.

The CLIA number assigned to this NPI record is 23D2245670 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2021 and was last updated on 3/19/2025.

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
1207Q00000XFamily MedicineYes

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: 3/30/2025

NPI Synchronization or Removal

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.

Previous NPI
Next NPI