{
"Npi": {
"NPI": "1811162928",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HANNA OBERTYNSKI M D P C",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2891 E MAPLE RD",
"SecondLineMailingAddress": "STE#200",
"MailingAddressCityName": "TROY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48083-6106",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-524-4000",
"MailingAddressFaxNumber": "248-524-0077",
"FirstLinePracticeLocationAddress": "2891 E MAPLE RD",
"SecondLinePracticeLocationAddress": "STE#200",
"PracticeLocationAddressCityName": "TROY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48083-6106",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-524-4000",
"PracticeLocationAddressFaxNumber": "248-524-0077",
"EnumerationDate": "04/29/2008",
"LastUpdateDate": "01/26/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OBERTYNSKI",
"AuthorizedOfficialFirstName": "HANNA",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "248-524-4000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "4301030536",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}