Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divine Medical Center P C

Organization General Practice Physician · NPI 1215284583

Divine Medical Center P C is a General Practice Physician in Detroit, Michigan. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

901 W Grand Blvd
Detroit, MI 48208-2353
Phone: (313) 393-3141
Fax: (313) 393-3144
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1215284583
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cermen Cardona — President · (313) 393-3141
NPI enumeratedAugust 6, 2012
Last updated in NPPESAugust 6, 2012
Mailing addressPo Box 806464, Saint Clair Shores, MI 48080-6464

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