Healthcare Provider Details
I. General information
NPI: 1144228917
Provider Name (Legal Business Name): CARL PALFFY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 12/16/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41800 W 11 MILE RD STE 109
NOVI MI
48375-1818
US
IV. Provider business mailing address
1749 E MAPLE RD
BIRMINGHAM MI
48009-6505
US
V. Phone/Fax
- Phone: 248-660-1220
- Fax: 248-256-3799
- Phone: 248-703-4148
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 4301052322 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | 4301052322 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | CP052322 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: