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NPI Code Detail

MEDICARE: M MEDICAL MI PLLC

MEDICARE: M MEDICAL MI PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1578377628
Entity Type Code : Organization
Provider Name (Legal Business Name) : M MEDICAL MI PLLC
Provider Business Mailing Address
First Line : 6 E EAGER ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21202-2506
Country : US
Telephone Number : 410-870-9380
Fax Number :
Provider Business Practice Location Address
First Line : 5201 CONNER ST
Second Line :
City : DETROIT
State : MI
Zip : 48213-3405
Country : US
Telephone Number : 313-571-5555
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : KRYSTLE D BROWN
Credential :
Telephone Number : 410-870-9380
Provider Enumeration Date : 02/06/2025
Last Update Date : 01/27/2026

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