{
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"FirstLineMailingAddress": "39500 HIGH POINTE BLVD STE 400",
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"MailingAddressCityName": "NOVI",
"MailingAddressStateName": "MI",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "39500 HIGH POINTE BLVD STE 400",
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"PracticeLocationAddressCityName": "NOVI",
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"EnumerationDate": "10/13/2023",
"LastUpdateDate": "10/13/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEWEY",
"AuthorizedOfficialFirstName": "ROBERT",
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"AuthorizedOfficialTitle": "CHIEF CLIENT OFFICER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "248-481-5178",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}