# PRIME GARDEN CITY MEDICAL GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIME GARDEN CITY MEDICAL GROUP
- **Other names:** Center for Sports and Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427208537
- **Legal business name:** PRIME GARDEN CITY MEDICAL GROUP
- **Authorized official:** MR. JOHN F MAGNUSON (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (734) 458-4490

## Contact information

- **Practice address:** 35600 CENTRAL CITY PKWY, SUITE 104, WESTLAND, MI 48185-2046
- **Practice address phone:** (734) 261-3778
- **Practice address fax:** (734) 524-0981
- **Mailing address:** 35600 CENTRAL CITY PKWY, SUITE 104, WESTLAND, MI 48185-2046
- **Mailing address phone:** (734) 261-3778
- **Mailing address fax:** (734) 524-0981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2008
- **Last updated:** 04/12/2017