Healthcare Provider Details

I. General information

NPI: 1770448920
Provider Name (Legal Business Name): MCLAREN COMMUNITY BASED PRIMARY CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 DIXIE HWY STE 3
CLARKSTON MI
48346-2092
US

IV. Provider business mailing address

G3235 BEECHER RD STE B
FLINT MI
48532-3650
US

V. Phone/Fax

Practice location:
  • Phone: 248-384-8300
  • Fax: 248-384-8301
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BINESH PATEL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 810-342-1041