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

Great Lakes Physicians of Redford, PLLC

Organization Internal Medicine Physician · NPI 1063682730

Great Lakes Physicians of Redford, PLLC is an Internal Medicine Physician in Redford, Michigan. Licensed in Michigan. Registered with an NPI since 2008.

Licensed in
MI
In the registry since
2008
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

25321 5 Mile Rd Ste # 1
Redford, MI 48239-3700
Phone: (313) 538-1800
Fax: (313) 538-9082
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 1630863 (MI)

Record details

NPI number1063682730
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mustak Vaid — Solo Owner · (248) 996-8777
NPI enumeratedMarch 9, 2008
Last updated in NPPESMarch 9, 2008
Mailing address23300 Providence Dr, Suite # 104, Southfield, MI 48075-3652

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