Provider Demographics
NPI: | 1699138750 |
---|---|
Name: | NEXTGEN PHYSICIANS PLC |
Entity type: | Organization |
Organization Name: | NEXTGEN PHYSICIANS PLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | PRAKASH |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | GANDHI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 248-827-7200 |
Mailing Address - Street 1: | 26222 TELEGRAPH RD |
Mailing Address - Street 2: | |
Mailing Address - City: | SOUTHFIELD |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48033-5318 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-827-2557 |
Mailing Address - Fax: | 248-827-2641 |
Practice Address - Street 1: | 414 UNION ST |
Practice Address - Street 2: | SUITE 100 |
Practice Address - City: | MILFORD |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48381-1987 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-676-8889 |
Practice Address - Fax: | 248-685-8039 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-04-05 |
Last Update Date: | 2016-12-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207Q00000X, 207RM1200X, 207U00000X, 207UN0901X, 207UN0902X, 208100000X, 2084N0400X, 2085B0100X, 2085N0904X, 2085R0202X, 2085R0204X, 2085U0001X, 208D00000X | ||
MI | 5101011367 | 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207RM1200X | Allopathic & Osteopathic Physicians | Internal Medicine | Magnetic Resonance Imaging (MRI) | Group - Multi-Specialty |
No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Multi-Specialty | |
No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Multi-Specialty |
No | 207UN0902X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Imaging & Therapy | Group - Multi-Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty |