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LIGHTHOUSE MEDICAL CENTER PC NPI 1659520237


NPI Information

NPI: 1659520237
Provider Name: LIGHTHOUSE MEDICAL CENTER PC

Doing Business As: LIGHTHOUSE MEDICAL CENTER PC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
8251 W 8 MILE RD
DETROIT, MI
ZIP 48221
Phone: (313) 345-8120
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LIGHTHOUSE MEDICAL CENTER PC is an internal medicine in Detroit, 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. LIGHTHOUSE MEDICAL CENTER PC NPI is 1659520237. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lighthouse Medical Center Pc.

The provider's business location address is:

8251 W 8 MILE RD
DETROIT, MI
ZIP 48221-195
Phone: (313) 345-8120
Fax: (313) 340-9032

The provider's authorized official is Willie James Pettiway .
The authorized official title is Medical Doctor and has the following contact phone number (313) 345-8120.

The enumeration date for this NPI number is 9/18/2008 and was last updated on 1/13/2011.


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 MedicineWPO49323MICHIGANYes

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
13023789MEDICAIDMICHIGAN
21108231742OTHERMICHIGANBLUE CROSS BLUE SHIELD
3C73891MEDICARE UPINMICHIGAN
408231748111MEDICARE 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: 4/28/2024

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