MICHAEL J CHARBONEAU JR DO PLLC (NPI# 1104092337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104092337 |
| Entity Type | Organization |
| Organization Name | MICHAEL J CHARBONEAU JR DO PLLC |
| Practice Address |
730 N Macomb St Suite 329 Monroe MI 48162-2900 |
| Practice Telephone | 7342414245 |
| Practice Fax Number | 7342428903 |
| Mailing Telephone | 7342414245 |
| Mailing Fax Number | 7342428903 |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | DR. MICHAEL JOSEPH CHARBONEAU JR. (OWNER) |
| Authorized Official Telephone | 7342414245 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 5101010247 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4218443 | 05 | |
| MI | BLUE CROSS | 0255810524 | 01 |
| Street Address |
730 N MACOMB ST SUITE 329 |
| City | MONROE |
| State | MI |
| Zip Code | 48162-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710983812 | Ashwin H Shah | Urology | 730 N Macomb St, Ste 319, Monroe, MI 48162 | 2005-06-23 |
| 1083959522 | Promedica Central Physicians LLC | Pediatrics | 730 N Macomb St, Suite 300, Monroe, MI 48162-2900 | 2012-12-11 |
| 1366721011 | Promedica Northwest Ohio Cardiology Consultants, LLC | Internal Medicine | 730 N Macomb St, Suite 429, Monroe, MI 48162-2900 | 2011-08-12 |
| 1659676708 | Promedica Monroe Cardiology, Pllc | Internal Medicine | 730 N Macomb St, Suite 429, Monroe, MI 48162-2900 | 2011-01-21 |
| 1760632962 | Monroe Arthritis Clinic Pllc | Internal Medicine | 730 N Macomb St, Suite 320, Monroe, MI 48162-2900 | 2008-09-24 |
| 1003091141 | Monroe Ear, Nose and Throat Associates, P.C. | Audiologist | 730 N Macomb St, Suite 320, Monroe, MI 48162-2900 | 2008-01-08 |
| 1467641951 | Usha R Tampi | Internal Medicine | 730 N Macomb St, Suite 229, Monroe, MI 48162-2900 | 2007-10-19 |
| 1407995822 | Ashwin H Shah Md PC | Urology | 730 N Macomb St, Suite 319, Monroe, MI 48162-2900 | 2007-02-05 |
| 1194893081 | Cardiology Consultants of Michigan & Ohio, P.C. | Specialist | 730 N Macomb St, Ste #429, Monroe, MI 48162-2900 | 2006-12-01 |
| 1386724987 | Lisa M Vick | Pharmacist | 730 N Macomb St, Monroe, MI 48162-2900 | 2006-10-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568016012 | Silke A Goudos | Nurse Practitioner | 730 N Macomb Street #200, Monroe, MI 48162 | 2019-08-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1740769702 | Carissa Pollock | Behavioral Analyst | 2086 S. Custer Rd., Monroe, MI 48162 | 2018-08-10 |
| 1710488440 | Stacy Michael Lucio | Nurse Practitioner | 901 N Macomb St Ste 109, Monroe, MI 48162 | 2018-02-27 |
| 1407239882 | Lisa Gilbert Peleman | Student in an Organized Health Care Education/Training Program | Promedica Monroe Regional Hospital Family Medicine Res, 650 Stewart Rd, Monroe, MI 48162 | 2015-07-03 |
| 1427430552 | Cheryl Fosgate | Counselor | 4350 N Monroe St, Monroe, MI 48162 | 2015-06-25 |
| 1538551460 | Convenient Mr PC | Dentist | 7500 N. Telegraph Rd., Monroe, MI 48162 | 2015-03-02 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1073872743 | Justin L Chamberlain | Surgery | 730 N Macomb St Ste 329, Monroe, MI 48162 | 2012-05-15 |
| 1639462674 | Toledo Clinic Incorporated | Durable Medical Equipment & Medical Supplies | 800 Stewart Road, Suite B, Monroe, MI 48162 | 2011-05-24 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336622158 | The Surgery Clinic of Northeast Louisiana LLC | Surgery | 1503 N 19th St, Monroe, LA 71201-4941 | 2018-09-07 |
| 1073872743 | Justin L Chamberlain | Surgery | 730 N Macomb St Ste 329, Monroe, MI 48162 | 2012-05-15 |
| 1811210917 | Union Physicians Network Inc | Surgery | 1423-b E Franklin Street, Monroe, NC 28112-5087 | 2010-03-04 |
| 1720259468 | William H. Bell IIi, D.o.,p.c. | Surgery | 905 N Macomb St Ste 4, Monroe, MI 48162-3076 | 2008-03-21 |
| 1699964858 | Georgia Laparospic Surgical Specialists PC | Surgery | 704 Breedlove Dr Ste B, Monroe, GA 30655-2054 | 2007-10-23 |
| 1487840013 | Edward B. Bower, Md, Pa | Surgery | 900 E Sunset Dr, A, Monroe, NC 28112-5893 | 2007-09-18 |
| 1871707661 | Cesar Medalla Delima | Surgery | 333 Alcovy Street, Suite 10, Monroe, GA 30655 | 2007-05-10 |
| 1316061179 | Richard Keith Jacob Jr. | Surgery | 2151 W Spring St Ste B210, Monroe, GA 30655 | 2007-03-19 |
| 1891880613 | William Henry Bell IIi | Surgery | 905 North Macomb Street Suite 4, Monroe, MI 48162 | 2006-10-04 |
| 1437161171 | Frank B Sartor | Surgery | 500 Hart St, Monroe, LA 71201-7504 | 2006-08-12 |
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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.