PRIME GARDEN CITY MEDICAL GROUP (NPI# 1033505110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033505110 |
| Entity Type | Organization |
| Organization Name | PRIME GARDEN CITY MEDICAL GROUP |
| Other Organization Name | B. NAKHLEH, M.D. |
| Practice Address |
4190 24th Ave Suite 206 Fort Gratiot MI 48059-3882 |
| Practice Telephone | 8102164000 |
| Practice Fax Number | 8102164001 |
| Mailing Telephone | 8102164000 |
| Mailing Fax Number | 8102164001 |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | MRS. DARLA SUE PARSONS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7344584490 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIME GARDEN CITY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| B. Nakhleh, M.D. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548802218 | Prime Garden City Medical Group | Internal Medicine | 6255 Inkster Rd Ste 302, Garden City, MI 48135-2538 | 2019-10-14 |
| 1508072729 | Prime Garden City Medical Group | Family Medicine | 30730 Ford Road, Garden City, MI 48135 | 2007-05-15 |
| 1437371739 | Prime Garden City Medical Group | Obstetrics & Gynecology | 6255 Inkster Road, Suite 203, Garden City, MI 48135 | 2007-05-03 |
| 1639391808 | Prime Garden City Medical Group | Internal Medicine | 8012 Middlebelt Road, Westland, MI 48185 | 2007-05-03 |
| 1598179954 | Prime Garden City Medical Group | Family Medicine | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2014-06-13 |
| 1104163013 | Prime Garden City Medical Group | Obstetrics & Gynecology | 6221 N Telegraph Rd, Dearborn Heights, MI 48127-3222 | 2013-01-11 |
| 1427208537 | Prime Garden City Medical Group | Family Medicine | 35600 Central City Pkwy, Suite 104, Westland, MI 48185-2046 | 2008-09-25 |
| 1023295722 | Prime Garden City Medical Group | Internal Medicine | 6255 Inkster Rd, Suite 101, Garden City, MI 48135-2577 | 2008-01-24 |
| 1538380621 | Prime Garden City Medical Group | Obstetrics & Gynecology | 30730 Ford Rd, Garden City, MI 48135-1803 | 2007-05-02 |
| 1063512010 | Prime Garden City Medical Group | Nuclear Medicine | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2006-09-22 |
| Street Address |
4190 24TH AVE SUITE 206 |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059-3882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629079611 | Newco Ambulatory Surgery Center, LLP | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2005-08-02 |
| 1518513027 | Aiso Pllc | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2019-08-12 |
| 1588109177 | Heather Kakos | Nurse Anesthetist, Certified Registered | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2017-01-05 |
| 1891246021 | Lake Huron Urgent Care Center, LLC | Internal Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-10-24 |
| 1134586852 | Prime Healthcare Services-port Huron, LLC | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-01-26 |
| 1598141640 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-07-30 |
| 1902281736 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Ste 206, Fort Gratiot, MI 48059-3882 | 2015-07-22 |
| 1003204660 | Beverlie Houser | Nurse Practitioner | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2015-01-06 |
| 1942615414 | Mercy Surgery Care Network | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2014-06-24 |
| 1740424001 | Rashim K Gupta | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2009-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1396756615 | Blue Water Family Dentistry PC | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059 | 2006-08-11 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| Find all providers in zip 48059 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457616120 | Gaurav Bhalla | Internal Medicine | 4190 24th Ave Ste 201, Fort Gratiot, MI 48059-3884 | 2012-07-09 |
| 1053582023 | Randy J. Plonka M.d. P.C. | Internal Medicine | 5979 Lakeshore Rd, Fort Gratiot, MI 48059-2826 | 2008-03-18 |
| 1962516286 | Vpa PC | Internal Medicine | 3081 Commerce Dr Ste 400, Fort Gratiot, MI 48059-3868 | 2006-08-17 |
| 1891246021 | Lake Huron Urgent Care Center, LLC | Internal Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-10-24 |
| 1598141640 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-07-30 |
| 1245424381 | Ahmad Alabbas | Internal Medicine | 3050 Commerce Dr, Suite B, Fort Gratiot, MI 48059-3819 | 2007-08-31 |
| 1437163409 | Port Huron Mercy Family Care Inc | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| Find all providers with the same taxonomy | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
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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.