DOMIAN KANDAH (NPI# 1013954585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013954585 |
| Entity Type | Individual |
| Full Name | DOMIAN KANDAH |
| Credential | D.O. |
| Practice Address |
11800 E 12 Mile Rd Warren MI 48093-3472 |
| Mailing Address |
307 S Evergreen Ave Woodbury NJ 08096-2739 |
| Practice Telephone | 5865735059 |
| Mailing Telephone | 8566864308 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2014-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
008716 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM/BCBS | 000000552888 | 01 |
| MI | 112905749 | 05 | |
| MI | 112905758 | 05 | |
| MI | 114206077 | 05 | |
| OH | MEDICARE RAILROAD | P00427186 | 01 |
| OH | 2791439 | 05 | |
| MI | BLUE SHIELD | DK008716 | 01 |
| MI | 112905533 | 05 | |
| MI | 114218327 | 05 |
| Street Address |
11800 E 12 MILE RD |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280940 | Manisha Kaur Bajwa | Pharmacist | 11800 E 12 Mile Rd, Pharmacy Department, Warren, MI 48093-3472 | 2005-07-28 |
| 1679181986 | Roxana Lionte | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-07-22 |
| 1649893355 | Patrick Yang | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-28 |
| 1831711936 | Elisheva Ellenberg | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-12 |
| 1427686716 | Pavan Kumar Ravipati | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-31 |
| 1962038885 | Natasha Mehta | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-23 |
| 1194350645 | Katherine Sara Streidl | Nurse Anesthetist, Certified Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-05 |
| 1891326898 | Clara Poparad-stezar | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-01-28 |
| 1023653797 | Lauren Ashley Shailor | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-11-16 |
| 1700428984 | Olivia Lynn Hedman | Dietitian, Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| 1316111263 | Belinda S Kakos | Emergency Medicine | 13355 E 10 Mile Rd, Warren, MI 48089-2048 | 2008-04-22 |
| 1679584387 | Brian Tenelshof | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1902817620 | St John Macomb-oakland Hospital | Emergency Medicine | 11800 E 12 Mile Rd, Er Department, Warren, MI 48093-3472 | 2006-08-10 |
| 1447269493 | David Donigian | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-08-07 |
| 1205840782 | Maureen L Dailey | Emergency Medicine | Er Dept, 118000 E 12th Mile Road, Warren, MI 48093 | 2006-07-28 |
| 1235159799 | Margaret Konsza | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
| 1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
| 1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
| 1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
| 1205849866 | Daryl D Wisdom | Emergency Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2006-08-14 |
| 1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
| 1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
| 1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
| 1740211655 | Chris Deva Samy | Emergency Medicine | 80 Grosse Pines Dr, Rochester Hills, MI 48309-1828 | 2006-07-06 |
| 1639101298 | Ronald A Farber | Emergency Medicine | 11177 Michigan Ave E, Battle Creek, MI 49014-8904 | 2006-07-06 |
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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.