Provider Demographics
NPI:1881635241
Name:MOTOR CITY INTERNISTS
Entity Type:Organization
Organization Name:MOTOR CITY INTERNISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-365-9740
Mailing Address - Street 1:7633 E JEFFERSON AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2513
Mailing Address - Country:US
Mailing Address - Phone:313-331-2650
Mailing Address - Fax:313-331-2690
Practice Address - Street 1:25925 TELEGRAPH RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2518
Practice Address - Country:US
Practice Address - Phone:248-746-3218
Practice Address - Fax:313-746-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M96000Medicare PIN