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SYLVAN LAKE FAMILY PRACTICE PLC NPI 1699880989


NPI Information

NPI: 1699880989
Provider Name: SYLVAN LAKE FAMILY PRACTICE PLC

Doing Business As: SYLVAN LAKE FAMILY PRACTICE PLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D1030893

Address:
2111 ORCHARD LAKE RD
SYLVAN LAKE, MI
ZIP 48320
Phone: (248) 451-1092
Get Directions

SYLVAN LAKE FAMILY PRACTICE PLC is a family medicine in Sylvan Lake, 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. SYLVAN LAKE FAMILY PRACTICE PLC NPI is 1699880989. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Sylvan Lake Family Practice Plc.

The provider's business location address is:

2111 ORCHARD LAKE RD
SYLVAN LAKE, MI
ZIP 48320-785
Phone: (248) 451-1092
Fax: (248) 451-1096

The provider's authorized official is Prakash Sanghvi .
The authorized official title is Owner and has the following contact phone number (248) 451-1092.

The CLIA number assigned to this NPI record is 23D1030893 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 6/8/2021.


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
1207Q00000XFamily MedicinePS066270MICHIGANYes

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
14743597MEDICAIDMICHIGAN
2G73042OTHERMICHIGANUPIN
30806348761OTHERMICHIGANBCBS
41730136961OTHERMICHIGANID NPI

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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