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

Revive Medical Group Mi PC

Organization Psychiatry Physician · NPI 1679304893

Revive Medical Group Mi PC is a Psychiatry Physician in Newaygo, Michigan. Registered with an NPI since 2024.

In the registry since
2024
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

231 W Pine Lake Dr
Newaygo, MI 49337-9264
Phone: (203) 430-1321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1679304893
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Ziyadeh — Ceo/Program Manager · (203) 430-1321
NPI enumeratedAugust 9, 2024
Last updated in NPPESAugust 9, 2024
Certification dateAugust 9, 2024
Mailing address81 Roanoke Ave, Fairfield, CT 06824-6124

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