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

Envision Medical Group PLLC

Organization Family Medicine Physician · NPI 1003125774

Envision Medical Group PLLC is a Family Medicine Physician in South Lyon, Michigan. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
5
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12660 Ten Mile Rd
South Lyon, MI 48178-9141
Phone: (248) 348-1131
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Diagnostic Radiology Physician Taxonomy 2085R0202X
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1003125774
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Wayne — Managing Member · (248) 348-8700
NPI enumeratedSeptember 29, 2010
Last updated in NPPESFebruary 23, 2021
Certification dateFebruary 23, 2021
Mailing address27275 Haggerty Rd Ste 500, Novi, MI 48377-3635

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