MS. EDITH ANNE CHITTENDEN (NPI# 1104161686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104161686 |
| Entity Type | Individual |
| Full Name | MS. EDITH ANNE CHITTENDEN |
| Credential | PA-C |
| Practice Address |
311 Mack Ave Ste 64100 Detroit MI 48201-2466 |
| Mailing Address |
1800 Orleans St Sheikh Zayed Tower 7107 Baltimore MD 21287-0010 |
| Practice Telephone | 3138320303 |
| Practice Fax Number | 3137459222 |
| Mailing Telephone | 4106142210 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2019-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Orleans St, Sheikh Zayed Tower 7107, Baltimore, MD 212870010 | 4106142210 |
| Street Address |
311 MACK AVE STE 64100 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548248354 | Kenton J Zehr | Surgery | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2006-01-03 |
| 1336695923 | Dianna Grace Ehlert | Registered Nurse | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2016-09-01 |
| 1043612567 | Justin Thomas Marzean | Physician Assistant | 311 Mack Ave Ste 64100, Detroit, MI 48201 | 2014-09-17 |
| 1073914214 | Joshua Hoover | Nurse Practitioner | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2014-09-08 |
| 1689091878 | Melanie Schwiesow | Surgery | 311 Mack Ave Ste 64100, Detroit, MI 48201 | 2014-03-25 |
| 1396091328 | Dave B Cuvi | Physician Assistant | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2012-07-27 |
| 1306191853 | Zaher Hakim | Internal Medicine | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2012-07-20 |
| 1689828238 | M. Chadi Alraies | Internal Medicine | 311 Mack Ave Ste 64100, Detroit, MI 48201 | 2008-11-10 |
| 1437315660 | Joan Frances Benedetti | Nurse Practitioner | 311 Mack Ave Ste 64100, Detroit, MI 48201-6712 | 2008-08-07 |
| 1457458929 | Franco L Fazzalari | Surgery | 311 Mack Ave Ste 64100, Detroit, MI 48201-2466 | 2006-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583994 | Isabella Lapuz Dela Cruz | Physician Assistant | 18463 Livernois Ave, Detroit, MI 48221-2254 | 2020-09-22 |
| 1932750684 | Patrick D Wharton | Physician Assistant | 5053 Commonwealth St # 1s, Detroit, MI 48208-2039 | 2019-09-24 |
| 1942869300 | Laura Dorothy Konsitzke | Physician Assistant | 22201 Moross Rd Ste 380, Detroit, MI 48236-2176 | 2019-06-10 |
| 1619419553 | Erica Ellen Schweitzer | Physician Assistant | 4701 Saint Antoine St Ste E-510, Detroit, MI 48201-1428 | 2016-11-09 |
| 1992167027 | Heather Michelle Sutton | Physician Assistant | 3901 Beaubien Drive, Detroit, MI 48201 | 2016-03-28 |
| 1659769107 | Zhi Li | Physician Assistant | 22201 Moross Rd Ste 370, Detroit, MI 48236 | 2015-01-07 |
| 1619371564 | Charlene Sharon Staff | Physician Assistant | 17701 Warwick St, Detroit, MI 48219-4210 | 2014-10-21 |
| 1245646025 | Sara Gibrael | Physician Assistant | 259 Mack Ave # 2590, Detroit, MI 48201-2427 | 2014-07-01 |
| 1497076434 | Mary Beth Morse | Physician Assistant | 4201 St. Antoine - Uhc 5d #226, University Pediatricians, Detroit, MI 48201-2153 | 2010-06-14 |
| 1265550487 | Claudine Lilla | Physician Assistant | 6071 W Outer Dr Dept Of, Detroit, MI 48235-2624 | 2007-03-26 |
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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.