ROBERT BULTEN (NPI# 1023177268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023177268 |
| Entity Type | Individual |
| Full Name | ROBERT BULTEN |
| Credential | M.D. |
| Practice Address |
4340 Burlingame Ave Sw Wyoming MI 49509-3770 |
| Practice Telephone | 6164757922 |
| Practice Fax Number | 6164757926 |
| Mailing Telephone | 6164757922 |
| Mailing Fax Number | 6164757926 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2009-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
4301028703 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3305965 | 05 |
| Street Address |
4340 BURLINGAME AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49509-3770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620713 | Lindsay Kayann Ottowitz | Behavior Technician | 1428 44th St. Sw, Wyoming, MI 49509 | 2020-08-23 |
| 1750990016 | Lindsay Alexandra Lyszczarz | Behavior Technician | 5281 Clyde Park Ave Se, Suite 2, Wyoming, MI 49509 | 2020-07-23 |
| 1033690409 | Courtney M Garner | Behavior Technician | 1428 44th Street, Wyoming, MI 49509 | 2018-08-23 |
| 1457857195 | Ashley Mae Autio | Case Manager/Care Coordinator | 795 36th Street, Wyoming, MI 49509 | 2018-04-02 |
| 1689124588 | Jacqeulyn Harmon | Behavioral Analyst | 2819 Peckheath Rd Sw Apt D, Wyoming, MI 49509 | 2016-10-04 |
| 1275988925 | Intsar Abdulahe | Social Worker | 1551 Charles Russell, Wyoming, MI 49509 | 2016-05-02 |
| 1992160071 | Concierge Home Care Services of West Michigan, LLC | Home Infusion | 1360 56th Street Sw, Wyoming, MI 49509 | 2015-12-16 |
| 1417349796 | Yashana Duncan | Case Manager/Care Coordinator | 225 Colrain St. Sw, Suite 2, Wyoming, MI 49509 | 2015-02-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
| Find all providers in zip 49509 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851505978 | Terry Marc Dickson | Pediatrics | 745 S Garfield Ave, Suite C, Traverse City, MI 49686-3479 | 2007-05-09 |
| 1144313107 | Cheryl Hope Hack | Pediatrics | 30301 Woodward Ave, Suite Ll 165, Royal Oak, MI 48073-0979 | 2006-10-02 |
| 1063449247 | Marsha Dawn Rappley | Pediatrics | A110 Clinical Ctr, 138 Service Rd, East Lansing, MI 48824-1313 | 2006-06-26 |
| 1073093290 | Rose Margret Thacker | Pediatrics | 32100 Telegraph Rd Ste 185, Bingham Farms, MI 48025-2453 | 2018-08-16 |
| 1073024469 | Alison Campos | Pediatrics | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2017-10-12 |
| 1114375292 | Nicole Patrice Hamp | Pediatrics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5718 | 2016-05-30 |
| 1487068383 | Robin Johnson Cook | Pediatrics | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2014-06-18 |
| 1134431968 | Meghan Ruth Behrmann | Pediatrics | 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2514 | 2010-07-09 |
| 1457566382 | William Beaumont Hospital | Pediatrics | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2007-05-14 |
| 1336353473 | The Behavioral Medicine Clinic of Northwest Michigan, Plc | Pediatrics | 745 S Garfield Ave, Suite C, Traverse City, MI 49686-3479 | 2007-05-09 |
| Find all providers with the same taxonomy | ||||
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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.