DR. JACLYN MILOSE (NPI# 1073741187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073741187 |
| Entity Type | Individual |
| Full Name | DR. JACLYN MILOSE |
| Credential | M.D. |
| Practice Address |
18100 Oakwood Blvd Ste 315 Dearborn MI 48124-4085 |
| Mailing Address |
20952 E 12 Mile Rd Ste 200 Saint Clair Shores MI 48081-3203 |
| Practice Telephone | 3132710066 |
| Practice Fax Number | 3132711047 |
| Mailing Telephone | 5867714820 |
| Mailing Fax Number | 5867716620 |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2019-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 4301117138 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0E06273 | 01 |
| RAILROAD MEDICARE | CB9133 | 01 |
| Street Address |
18100 OAKWOOD BLVD STE 315 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-4085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730126228 | Jeffrey Alan Triest | Urology | 18100 Oakwood Blvd Ste 315, Dearborn, MI 48124-4085 | 2006-06-01 |
| 1316106537 | Wassim Moussa Bazzi | Urology | 18100 Oakwood Blvd Ste 315, Dearborn, MI 48124-4085 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730126228 | Jeffrey Alan Triest | Urology | 18100 Oakwood Blvd Ste 315, Dearborn, MI 48124-4085 | 2006-06-01 |
| 1114257540 | Dynamic Urocare PC | Urology | 18100 Oakwood Blvd, Ste 315, Dearborn, MI 48124-4085 | 2010-01-07 |
| 1316106537 | Wassim Moussa Bazzi | Urology | 18100 Oakwood Blvd Ste 315, Dearborn, MI 48124-4085 | 2008-06-03 |
| 1508024977 | Amarnath Rambhatla | Urology | 18100 Oakwood Blvd, Ste 300, Dearborn, MI 48124-4085 | 2008-06-01 |
| 1346440526 | Nivedita Dhar | Urology | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2007-07-25 |
| 1821292616 | Steven Mark Lucas | Urology | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2007-06-13 |
| 1407918071 | Bp Sinha Md PC | Urology | 2841 Monroe St, Suite#1, Dearborn, MI 48124-3492 | 2006-12-13 |
| 1871673962 | Michigan Institute of Urology PC | Urology | 18100 Oakwood Blvd, Suite 315, Dearborn, MI 48124-4085 | 2006-10-16 |
| 1073543989 | Bageshwari Prasad Sinha | Urology | 2841 Monroe St, Suite #2, Dearborn, MI 48124-3492 | 2006-07-04 |
| 1316902786 | Jorge R Torriglia | Urology | 18100 Oakwood Blvd, Suite 315, Dearborn, MI 48124-4071 | 2006-04-19 |
| Find all providers in DEARBORN | ||||
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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.