{
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"FirstLineMailingAddress": "159 KERCHEVAL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GROSSE POINTE FARMS",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48236",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-640-2578",
"MailingAddressFaxNumber": "313-640-2583",
"FirstLinePracticeLocationAddress": "159 KERCHEVAL RD",
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"PracticeLocationAddressCityName": "GROSSE POINTE FARMS",
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"PracticeLocationAddressTelephoneNumber": "313-640-2578",
"PracticeLocationAddressFaxNumber": "313-640-2583",
"EnumerationDate": "06/24/2009",
"LastUpdateDate": "07/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAFARO",
"AuthorizedOfficialFirstName": "BETH",
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"AuthorizedOfficialTitle": "VP, PHYSICIAN PRACTICE DEVELOPEMENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "313-640-2426",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Surgery Physician",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}