Healthcare Provider Details

I. General information

NPI: 1255388898
Provider Name (Legal Business Name): MACOMB PHYSICIANS GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 METROPOLITAN PKWY SUITE C
STERLING HEIGHTS MI
48312-2778
US

IV. Provider business mailing address

8244 METROPOLITAN PKWY SUITE C
STERLING HEIGHTS MI
48312-2778
US

V. Phone/Fax

Practice location:
  • Phone: 586-795-4060
  • Fax: 586-795-5595
Mailing address:
  • Phone: 586-795-4060
  • Fax: 586-795-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4301073989
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER L MURRAY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 586-795-4060