ST JOHN MACOMB OAKLAND HOSPITAL (NPI# 1013174655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013174655 |
| Entity Type | Organization |
| Organization Name | ST JOHN MACOMB OAKLAND HOSPITAL |
| Practice Address |
7733 E Jefferson Ave Detroit MI 48214-3707 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 3134994000 |
| Mailing Telephone | 5867530275 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | RANDOLPH KRUMMLER (VP FINANCE) |
| Authorized Official Telephone | 5865735910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS | 0Q27621 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578891966 | St John Macomb Oakland Hospital | Audiologist | 11800 E 12 Mile Rd, Suite 1829, Warren, MI 48093-3472 | 2009-11-24 |
| 1033376538 | St John Macomb Oakland Hospital | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1811154628 | St John Macomb Oakland Hospital | Pediatrics | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1427215235 | St John Macomb Oakland Hospital | Radiology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1770750309 | St John Macomb Oakland Hospital | General Acute Care Hospital | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-13 |
| 1811102742 | St John Macomb Oakland Hospital | Pathology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2007-05-14 |
| Street Address |
7733 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48214-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881681955 | Patricia Barszenski | Nurse Practitioner | 7733 E Jefferson Ave, 1350, Detroit, MI 48214-3707 | 2005-10-04 |
| 1790030690 | Ccla9, LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2012-07-17 |
| 1295018745 | Ccla 9 LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2011-09-21 |
| 1629216007 | Lakshmi Subba Nellutla | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2009-01-23 |
| 1922257401 | Medical Resource Group | Clinic/Center | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-09-09 |
| 1033376538 | St John Macomb Oakland Hospital | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1770750309 | St John Macomb Oakland Hospital | General Acute Care Hospital | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-13 |
| 1245406875 | Dr. Kerry L. Kole PC | Surgery | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-04 |
| 1871783530 | Medical Resource Group | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2007-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376042325 | Tamara Wesley | Registered Nurse | 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 | 2018-02-06 |
| 1720534381 | Birth Beautiful Detroit | Clinic/Center | 1086 Baldwin, Detroit, MI 48214 | 2016-09-01 |
| 1225402886 | Steven Doyle Whatley I | Counselor | 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 | 2015-11-19 |
| 1255587945 | Andrew Avery | Internal Medicine | 7733 East Jefferson Ave, Detroit, MI 48214 | 2008-08-13 |
| 1639330210 | Nicole Lashawn Greene | Specialist | 4533 St Clair St, Detroit, MI 48214 | 2008-06-17 |
| 1629299433 | Alan R Faber Jr. | Dentist | 8191 E Jefferson Ave, Detroit, MI 48214 | 2007-05-01 |
| 1518188598 | Mary F Bridges | Psychiatry & Neurology | 8120 East Jefferson #3l, Detroit, MI 48214 | 2007-05-01 |
| 1053439737 | Geraldine Etella Davis | Counselor | 3840 Fairview St., Detroit, MI 48214 | 2007-03-27 |
| 1639203482 | Detroit-macomb Hospital Corporation | Advanced Practice Midwife | 7815 E. Jefferson, Detroit, MI 48214 | 2007-03-15 |
| 1033275441 | Anesha Amor Rouse | Physical Therapy Assistant | 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 | 2006-12-29 |
| Find all providers in zip 48214 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1144636895 | Ramya Gadde | Pathology | 2799 W.grand Boulevard,henry Ford Hospital, Detroit, MI 48202-2608 | 2014-07-02 |
| 1316202997 | Umer Nisar Sheikh | Pathology | 22101 Moross Rd # Ccb-sb, St. John Hospital & Medical Center, Dept of Pathology, Detroit, MI 48236-2148 | 2012-07-10 |
| 1053521799 | Jyotinder Nain Punia | Pathology | Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202-2608 | 2007-05-23 |
| 1093924466 | Kewang Li | Pathology | 4500 Cass Ave, Apt#1010, Detroit, MI 48201-1288 | 2007-05-22 |
| 1760422638 | John D Crissman | Pathology | 9374 Scott Hall 540 E Canfield Ave, Wayne State University School of Medicine, Detroit, MI 48201-1928 | 2006-06-07 |
| 1336187061 | Lucia A Schuger | Pathology | Detroit Receiving Hospital Pathology, 4201 St Antoine Ste 3e, Detroit, MI 48201 | 2006-06-03 |
| 1992743017 | Husain A Saleh | Pathology | Sinai Grace Hospital Pathology, 6071 W Outer Dr, Detroit, MI 48235 | 2006-06-02 |
| 1851338842 | Shashi K Madan | Pathology | Harper Hospital Pathology, 3990 John R, Detroit, MI 48201-2097 | 2006-05-31 |
| 1205873296 | Raj Dulari Bhan | Pathology | Hutzel Hospital Pathology, 4707 St Antoine, Detroit, MI 48201 | 2006-05-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.