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

Providence Park Internal Medicine PC

Organization Internal Medicine Physician · NPI 1487052619

Providence Park Internal Medicine PC is an Internal Medicine Physician in Novi, Michigan. Licensed in Michigan. Registered with an NPI since 2014.

Licensed in
MI
In the registry since
2014
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

26850 Providence Pkwy Ste 450
Novi, MI 48374-1213
Phone: (248) 891-4074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 4301089716 (MI)

Record details

NPI number1487052619
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Suha Qasim — President · (248) 891-4074
NPI enumeratedDecember 22, 2014
Last updated in NPPESJanuary 7, 2015
Mailing address26850 Providence Pkwy, Suite 450, Novi, MI 48374-1213

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