KIDNEY CENTER OF MICHIGAN (NPI# 1083983498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083983498 |
| Entity Type | Organization |
| Organization Name | KIDNEY CENTER OF MICHIGAN |
| Practice Address |
44555 Woodward Ave Suite 404 Pontiac MI 48341-5031 |
| Mailing Address |
Po Box 71026 Rochester Hills MI 48307-0019 |
| Practice Telephone | 2488583011 |
| Practice Fax Number | 8004141646 |
| Mailing Telephone | 2488583011 |
| Mailing Fax Number | 8004141646 |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2012-02-24 |
| Authorized Official Name | AMITH KAKULAVARAM (PRESIDENT) |
| Authorized Official Telephone | 2488583011 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
4301084121 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | 4301084121 | 01 |
| Street Address |
44555 WOODWARD AVE SUITE 404 |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659379758 | Donald Dino Bignotti | Family Medicine | 44555 Woodward Ave, Suite 402, Pontiac, MI 48341-5031 | 2005-07-12 |
| 1477002236 | Bloomfield Heart Center Pllc | Internal Medicine | 44555 Woodward Ave, Suite 403, Pontiac, MI 48341-5031 | 2016-09-22 |
| 1699124503 | Stroke Team One | Psychiatry & Neurology | 44555 Woodward Ave, Suite 104, Pontiac, MI 48341-5031 | 2016-06-10 |
| 1164800843 | Vincent James Krolikowski | Nurse Practitioner | 44555 Woodward Ave, Ste. 302, Pontiac, MI 48341-5031 | 2015-05-13 |
| 1699180505 | David Bracho | Anesthesiology | 44555 Woodward Ave, St. Joseph Mercy Oakland Mob Room 308, Pontiac, MI 48341-5031 | 2014-06-30 |
| 1538570189 | Reem Almuqati | Student in an Organized Health Care Education/Training Program | 44555 Woodward Ave, Suite 308, Pontiac, MI 48341-5031 | 2014-05-16 |
| 1740577170 | Ronald L Vandermolen | Surgery | 44555 Woodward Ave, Suite 501, Pontiac, MI 48341-5031 | 2011-07-06 |
| 1194011643 | Oakland Digestive Disease,pllc | Specialist | 44555 Woodward Ave, Ste 304, Pontiac, MI 48341-5035 | 2011-06-23 |
| 1174833081 | Ned Z Winkelman Md PC | Plastic Surgery | 44555 Woodward Ave, Suite 404, Pontiac, MI 48341-5031 | 2010-10-13 |
| 1962635169 | Allen Silbergleit Md PC | Surgery | 44555 Woodward Ave, Suite 404, Pontiac, MI 48341-5031 | 2009-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1235286055 | Stephen D. Clyne | Internal Medicine | 44200 Woodward Ave, Suite 209, Pontiac, MI 48341-5045 | 2007-01-04 |
| 1124095948 | Ghadeer Noel Hannoudi | Internal Medicine | 44200 Woodward Ave, Suite 209, Pontiac, MI 48341-5045 | 2006-03-01 |
| 1033186861 | Kalyana S Ramamurthi | Internal Medicine | 44200 Woodward Ave, Suie 209, Pontiac, MI 48341-5045 | 2006-03-01 |
| 1922075753 | Usman G Master | Internal Medicine | 44200 Woodward Ave, Suite 209, Pontiac, MI 48341-5045 | 2006-03-01 |
| 1073584223 | Fahd Al-saghir | Internal Medicine | 44200 Woodward Ave, Suite 209, Pontiac, MI 48341-5045 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440439 | Nephrocare Dialysis, LLC | Internal Medicine | Garden City Hosptial, 6245 Inkster Road, Garden City, MI 48135 | 2020-02-25 |
| 1740823459 | Critical Care Nephrology, PC | Internal Medicine | 333 E Parent Ave, Royal Oak, MI 48067-3748 | 2019-10-25 |
| 1568948537 | Amanda Thelen | Internal Medicine | 405 W Greenlawn Ave Ste 230, Lansing, MI 48910-0812 | 2018-07-12 |
| 1023507357 | James Francis Murphy | Internal Medicine | Hope Medical Clinic 518 Harriet St., Ypsilanti, MI 48197-0311 | 2018-05-02 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1982129805 | Abhay Mishra | Internal Medicine | 4160 John R St Ste 908, Detroit, MI 48201-2017 | 2017-08-11 |
| 1326586959 | Alhaji Consultant Pllc | Internal Medicine | 29201 Chateau Ct, Farmington Hills, MI 48334-4112 | 2017-02-02 |
| 1033669445 | T-beyene Hypertension & Kidney Care Plc | Internal Medicine | 4160 John R Ste 1011, Harper Professional Building, Detroit, MI 48201 | 2016-10-10 |
| 1285085860 | Omer Yousif | Internal Medicine | 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 | 2016-06-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KIDNEY CENTER OF MICHIGAN.
| 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.