FASTER CARE CONNOR CREEK, PLLC (NPI# 1063069359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063069359 |
Entity Type | Organization |
Organization Name | FASTER CARE CONNOR CREEK, PLLC |
Practice Address |
4777 E Outer Dr Detroit MI 48234-3241 |
Practice Telephone | 2487024961 |
Mailing Telephone | 2487024961 |
Enumeration Date | 2019-08-21 |
Last Update Date | 2019-08-21 |
Authorized Official Name | ERIC GREENBERG (OWNER) |
Authorized Official Telephone | 2487024961 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | FASTER CARE CONNOR CREEK, PLLC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
4777 E OUTER DR |
City | DETROIT |
State | MI |
Zip Code | 48234-3241 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841230745 | Carla M Smith | Social Worker | 4777 E Outer Dr, Ste 183, Detroit, MI 48234-3241 | 2006-06-08 |
1962018457 | A Baby's Life, LLC | Case Management | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2020-09-20 |
1154933265 | Healing House, LLC | Community/Behavioral Health | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2020-08-19 |
1063063295 | Allison Jay | Dietitian, Registered | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-09-29 |
1699335562 | Sidney Sharee-celestine Sparks | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-06-13 |
1417420514 | Alyssia Chantel Hence | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-01-10 |
1164917639 | Conner Creek Life Solutions LLC | Substance Abuse Rehabilitation Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2018-06-27 |
1790292928 | Golden Point Community LLC | Assisted Living Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2018-01-09 |
1154850543 | Stephanie Graves | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2017-06-08 |
1285189977 | Brian Kendall | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2016-08-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205332483 | Bryce Xavier Bredell | Student in an Organized Health Care Education/Training Program | 6071 E Outer Dr, Detroit, MI 48234 | 2018-04-05 |
1538668595 | Constance Durden | Social Worker | 19940 Conant Suite B, Detroit, MI 48234 | 2018-02-06 |
1891217717 | Donald Williams | Case Manager/Care Coordinator | 19133 Hasse, Detroit, MI 48234 | 2017-07-12 |
1063865830 | Gloria A. Love | Psychologist | 19677 Revere, Detroit, MI 48234 | 2016-07-18 |
1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
1861878787 | Kenyatta Philips | Chore Provider | 20119 Helen St, Detroit, MI - MICHIGAN 48234 | 2015-08-03 |
1083977144 | Edward Powell | Counselor | 19436 Packard Street, Detroit, MI 48234 | 2012-06-22 |
1487931325 | Sonia Renee George | Case Manager/Care Coordinator | 8331 Yolanda St., Detroit, MI 48234 | 2011-11-07 |
1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
1558662742 | Tenille Daniel | Home Health | 17210 Runyon, Detroit, MI 48234 | 2010-11-04 |
Find all providers in zip 48234 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942618228 | Changes | Internal Medicine | 19940 Conant St, Detroit, MI 48234-1494 | 2014-07-30 |
1841391323 | Prince Jerome Eubanks | Internal Medicine | 20526 Plymouth Rd, Detroit, MI 48228-1201 | 2006-09-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013367473 | East & West Physicians PC | Internal Medicine | 20905 Greenfield Rd Ste 608, Southfield, MI 48075-5355 | 2016-06-16 |
1033445861 | Ayad M George, Pllc | Internal Medicine | 2132 Cedar St, Holt, MI 48842-1458 | 2009-10-29 |
1588821433 | West Michigan Addiction Consultants, PC | Internal Medicine | 3001 Fuller Ave Ne, Suite 1, Grand Rapids, MI 49505-3247 | 2008-05-19 |
1922108927 | Rudy Jerome Vervaeke | Internal Medicine | 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 | 2006-09-22 |
1730727850 | Dearborn Pain Center Pllc | Internal Medicine | 624 E 9 Mile Rd, Hazel Park, MI 48030-1842 | 2019-12-19 |
1356869572 | America Recovery Center, Pllc | Internal Medicine | 20217 Ann Arbor Trl, Dearborn Heights, MI 48127-2692 | 2017-09-07 |
1356793954 | Iha Health Services Corporation | Internal Medicine | 5333 Mcauley Dr Rm 5011, Ypsilanti, MI 48197-1003 | 2016-07-07 |
1770967226 | Newhorizon Center LLC | Internal Medicine | 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1999 | 2015-07-15 |
1033434253 | Elizabeth Bulat | Internal Medicine | 37595 7 Mile Rd, # 240, Livonia, MI 48152-1003 | 2010-03-30 |
1154508455 | Charles Frederick Gehrke | Internal Medicine | 12851 Grand River Rd, Brighton, MI 48116 | 2008-01-29 |
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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.