1477436293 NPI number — THRIVE ENDOCRINOLOGY & DIABETES CARE, PLLC

Table of content: (NPI 1477436293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477436293 NPI number — THRIVE ENDOCRINOLOGY & DIABETES CARE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THRIVE ENDOCRINOLOGY & DIABETES CARE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1477436293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3588 PLYMOUTH RD # 302
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48105-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-615-9094
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
760 W EISENHOWER PKWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48103-6196
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-888-6712
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2025

Additional Information

Authorized Official

Authorized Official Last Name:
HE
Authorized Official First Name:
XIN
Authorized Official Middle Name:
N/A
Authorized Official Title or Position:
ENDOCRINOLOGIST
Authorized Official Telephone Number:
617-615-9094

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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