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

Michigan Medical Mall

Organization Family Medicine Physician · NPI 1194133686

Michigan Medical Mall is a Family Medicine Physician in Detroit, Michigan. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

17350 Livernois Ave
Detroit, MI 48221-2759
Phone: (256) 262-9310
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1194133686
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Schara Davis — Owner/Incorporator · (256) 262-9310
NPI enumeratedJuly 28, 2014
Last updated in NPPESJuly 28, 2014
Mailing address17350 Livernois Ave, Detroit, MI 48221-2759

Other providers in Detroit