Healthcare Provider Details

I. General information

NPI: 1659021509
Provider Name (Legal Business Name): SMS MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18254 LIVERNOIS AVE
DETROIT MI
48221-4214
US

IV. Provider business mailing address

18254 LIVERNOIS AVE
DETROIT MI
48221-4214
US

V. Phone/Fax

Practice location:
  • Phone: 313-880-1053
  • Fax: 313-646-4072
Mailing address:
  • Phone: 313-880-1053
  • Fax: 313-646-4072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUMANA F NAGARWALA
Title or Position: OWNER
Credential: MD
Phone: 313-880-1053