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Contact Information

MILLENNIUM MEDICAL GROUP SOUTH PC
9340 TELEGRAPH RD
TAYLOR, MI48180-3362
 Phone: 313-295-3388
 Fax: 313-295-4198
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Diagnostic Ultrasound

2085U0001X
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Nuclear Imaging & Therapy

207UN0902X 36 Physician/Nuclear Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for MILLENNIUM MEDICAL GROUP SOUTH PC

NPI # 1265468623
LBN Legal business name MILLENNIUM MEDICAL GROUP SOUTH PC
Authorized official ABRAHAM SLAIM - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/25/2006
Last updated 08/19/2008 - About 18 years ago
Identifiers
MI Other 500H255490 BLUE SHIELD
MI Other 700H222490 BLUE SHIELD GROUP
MI Other DD9487 MEDICARE ID TYPE UNSPECIFIED
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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