MCLAREN MACOMB (NPI# 1083669691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083669691 |
| Entity Type | Organization |
| Organization Name | MCLAREN MACOMB |
| Practice Address |
1000 Harrington Blvd. Attn: Special Care Nursery Mt. Clemens MI 48043 |
| Mailing Address |
1000 Harrington Blvd. Attn: Special Care Nursery Mt. Clemens MI 48043-2920 |
| Practice Telephone | 5864938296 |
| Practice Fax Number | 5867414114 |
| Mailing Telephone | 5864938296 |
| Mailing Fax Number | 5867414114 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | MR. THOMAS M BRISSE (CEO) |
| Authorized Official Telephone | 5864938083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301085002 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4819971 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821040288 | Mclaren Macomb | Family Medicine | 8180 26 Mile Rd., Ste. 101, Shelby Township, MI 48316 | 2006-05-16 |
| 1033710116 | Mclaren Macomb | Rehabilitation Unit | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-11-04 |
| 1013256296 | Mclaren Macomb | Emergency Medicine | 39833 Bridgeview St, Harrison Township, MI 48045 | 2013-02-07 |
| 1396014601 | Mclaren Macomb | Family Medicine | 1000 Harrington Blvd., Mount Clemens, MI 48043 | 2011-12-16 |
| 1922316140 | Mclaren Macomb | General Acute Care Hospital | 1000 Harrington St, Mount Clemens, MI 48043 | 2010-09-22 |
| 1063690857 | Mclaren Macomb | Pediatrics | 1000 Harrington St, Mount Clemens, MI 48043 | 2008-02-05 |
| 1528258654 | Mclaren Macomb | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043 | 2007-07-25 |
| 1437270311 | Mclaren Macomb | Family Medicine | 36500 S Gratiot Ave, Suite 202, Clinton Township, MI 48035 | 2007-04-02 |
| 1215057609 | Mclaren Macomb | Internal Medicine | 36500 S Gratiot Ave, Suite 102, Clinton Township, MI 48035 | 2007-03-30 |
| 1124148515 | Mclaren Macomb | Surgery | 36500 S Gratiot Ave, Suite 102, Clinton Township, MI 48035 | 2007-03-30 |
| Street Address |
1000 HARRINGTON BLVD. ATTN: SPECIAL CARE NURSERY |
| City | MT. CLEMENS |
| State | MI |
| Zip Code | 48043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154761245 | Evan Patrick Coyne | Emergency Medicine | 1000 Harrington Blvd., Mt. Clemens, MI 48043 | 2013-07-03 |
| 1285683375 | Athi Narayan | Pediatrics | 1000 Harrington Blvd., Mt. Clemens, MI 48043-2920 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700498946 | Positively Pediatrics Pllc | Pediatrics | 120 N Bridge St Ste D, Linden, MI 48451-8823 | 2020-08-19 |
| 1730708058 | Xuexin Lu | Pediatrics | 22101 Moross Rd Ste 80, Detroit, MI 48236-2148 | 2020-04-16 |
| 1083252324 | Faith Cares Inc | Pediatrics | 9633 Sil St, Taylor, MI 48180-3028 | 2019-12-17 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1528611175 | Emad Kassas | Pediatrics | 358 E Chicago St Ste C, Coldwater, MI 49036-2072 | 2019-07-23 |
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1811553597 | Emile Muallem | Pediatrics | 1500 E. Med. Ctr Dr, Ann Arbor, MI 48109-5718 | 2019-05-17 |
| 1215403597 | Mfed Mosely | Pediatrics | 21840 23rd Mile Road, Macomb Twnp, MI 48040-2496 | 2018-10-15 |
| 1811473234 | Joyful Pediatrics, Pllc | Pediatrics | 820 Byron Rd Ste 600, Howell, MI 48843-1072 | 2018-07-18 |
| 1386139913 | Southfield Pediatrics Pllc | Pediatrics | 28500 Southfield Rd Ste 100, Lathrup Village, MI 48076-2722 | 2018-06-26 |
| Find all providers with the same taxonomy | ||||
| City | MT. CLEMENS |
| Zip Code | 48043 |
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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.