MARIE KONCZALSKI (NPI# 1104886894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104886894 |
| Entity Type | Individual |
| Full Name | MARIE KONCZALSKI |
| Credential | MD |
| Practice Address |
44201 Dequindre Rd Beaumont Hospital - Troy Troy MI 48085-1117 |
| Mailing Address |
130 Town Center Dr Ste 203 Beaumont Physician Partners Payor Enrollment Troy MI 48084-1744 |
| Practice Telephone | 2489645190 |
| Practice Fax Number | 2489645199 |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2017-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301405979 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
44201 DEQUINDRE RD BEAUMONT HOSPITAL - TROY |
| City | TROY |
| State | MI |
| Zip Code | 48085-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892468 | Mary Margaret Guerra | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2005-06-28 |
| 1578163523 | Laura Marie Metz | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-29 |
| 1538767983 | Virginia Clare Fielhauer | Physician Assistant | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-16 |
| 1437756095 | Amanda Michelle Hirsch | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-07 |
| 1467059113 | Scott Matthew Grumeretz | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
| 1285231944 | Brianne Patton | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
| 1679180483 | John L Freds | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-25 |
| 1720694300 | Justine Marie Doss | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-19 |
| 1649885872 | Sara Dawn Thueme | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-14 |
| 1316561772 | Jodi Marini | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
| 1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
| 1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
| 1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
| 1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
| 1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
| 1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
| 1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
| Find all providers in zip 48085 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811221104 | Carl E Farah | Radiology | 1616 Kirts Blvd, 206, Troy, MI 48084-4348 | 2009-09-21 |
| 1558591024 | Paul Thottakara | Radiology | 3088 Glouchester Dr, Troy, MI 48084-2715 | 2009-07-20 |
| 1487883427 | Alexander Elhilal | Radiology | 1113 Birchwood Dr, Troy, MI 48083-1807 | 2009-07-13 |
| 1124286190 | Robert Warren Mendelson | Radiology | 2541 Manchester Ct, Troy, MI 48098-2146 | 2008-05-27 |
| 1457522625 | Seetha S Vakhariya | Radiology | 3290 Camden Dr, Troy, MI 48084-7027 | 2008-03-17 |
| 1194915660 | Danny Ma | Radiology | 2099 Hartshorn Ave, Troy, MI 48083-1760 | 2007-07-30 |
| 1699849000 | Joseph Carroll Andrews | Radiology | 5762 Greenhill Dr, Troy, MI 48098-5341 | 2006-11-17 |
| 1912088808 | Bhargavi Kanubhai Patel | Radiology | 1000 East Cherry Street, Lincoln County Medical Center Dept of Radiology, Troy, MO 63379 | 2006-10-18 |
| 1700985744 | Timothy L Eakes Jr. | Radiology | 1330 Highway 231 South, Troy, AL 36081 | 2006-09-22 |
| 1043265234 | Yagnesh Rameshwar Raval | Radiology | 3130 North Dixie Highway, Imaging Department, Troy, OH 45373-1309 | 2006-05-24 |
| Find all providers in TROY | ||||
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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.