OrganizationActive
Michigan Medical Mall
NPI 1194133686 · Family Medicine Physician · Detroit, MI
Provider details
- NPI number
- 1194133686
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Schara Davis, Owner/Incorporator(256) 262-9310
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17350 Livernois Ave
Detroit, MI 48221-2759
Phone: (256) 262-9310
Street-level locationGet directions
Mailing address
17350 Livernois Ave
Detroit, MI 48221-2759
Registry dates
- Enumerated
- 2014-07-28
- Last updated
- 2014-07-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.