DR. MICHAEL WILLIAM SULLIVAN (NPI# 1164531042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164531042 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL WILLIAM SULLIVAN |
| Credential | D.O. |
| Practice Address |
16700 21 Mile Rd Suite 101 Macomb MI 48044-4887 |
| Practice Telephone | 5862630320 |
| Practice Fax Number | 5862631276 |
| Mailing Telephone | 5862630320 |
| Mailing Fax Number | 5862631276 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2011-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101007472 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0855010004 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918617 | Michael David Sullivan | Social Worker | 403 1/2 Hector St, Ithaca, NY 14850-2025 | 2018-10-15 |
| 1376923292 | Michael Sullivan | Student in an Organized Health Care Education/Training Program | Walter Reed 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2015-06-05 |
| 1881074896 | Michael Gregory Sullivan | Intermediate Care Facility, Mentally Retarded | 30 Hobomack Rd, Quincy, MA 02169-2508 | 2015-06-04 |
| 1104215136 | Michael Sullivan | Perfusionist | 137 Founders Way Ct, Cape Girardeau, MO 63701-9442 | 2015-01-14 |
| 1689927915 | Michael Robert Sullivan | Pharmacist | 41 Buena Vista St, Stamford, CT 06907-2402 | 2012-10-24 |
| 1154672038 | Michael James Sullivan | Dentist | 1882 Hard Rd, Columbus, OH 43235-1996 | 2012-10-02 |
| 1063791747 | Michael Gruer Sullivan | Counselor | 2024 N. Crystal Lake Dr., Suite 200 Room 205, Lakeland, FL 33801-6015 | 2011-08-11 |
| 1457647083 | Michael Patrick Sullivan | Dentist | 1008 G Sreet, Geneva, NE 68361 | 2011-06-22 |
| 1841528585 | Michael Andrew Sullivan | Counselor | 974 73rd St Ste 9, Windsor Heights, IA 50324-1026 | 2009-11-18 |
| 1508191388 | Michael Joseph Sullivan | Audiologist | 6644 Penn Ave S, Richfield, MN 55423-2026 | 2009-10-12 |
| Street Address |
16700 21 MILE RD SUITE 101 |
| City | MACOMB |
| State | MI |
| Zip Code | 48044-4887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255363065 | Mario N Coraci | Podiatrist | 16700 21 Mile Rd, Suite #102, Macomb, MI 48044-4887 | 2006-07-06 |
| 1346425568 | Mario N Coraci PC | Podiatrist | 16700 21 Mile Rd, Suite 102, Macomb, MI 48044-4887 | 2008-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265925788 | Karen Wetzel | Social Worker | 47567 Dennis Baert Dr, Macomb, MI 48044 | 2018-06-09 |
| 1225541956 | Paul John Andary Jr. | Student in an Organized Health Care Education/Training Program | 48599 Penrose Ln, Macomb, MI 48044 | 2017-11-16 |
| 1467972869 | Theresa Lynn Cipponeri | Social Worker | 17937 Hall Road, Macomb, MI 48044 | 2017-06-27 |
| 1407389570 | Nofal Cholag | Pharmacist | 50340 Nesting Ridge Dr, Macomb, MI 48044 | 2017-04-06 |
| 1043754914 | Magdalena Sosnowski | Registered Nurse | 47362 Whippoorwill Dr, Macomb, MI 48044 | 2016-12-13 |
| 1558716894 | Keith Edward Callewaert | Emergency Medical Technician, Paramedic | 48301 Tonawonda Dr, Macomb, MI 48044 | 2016-04-24 |
| 1942684741 | Isabella Scofield | Family Medicine | 46591 Romeo Plank Rd Ste 200, Macomb, MI 48044 | 2015-07-13 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1699118455 | Kostyantyn Shkilnyy | Massage Therapist | 48254 Ellington Drive, Macomb Township, MI 48044 | 2013-04-11 |
| 1962790097 | Daniel Agrusa | Audiologist | 49306 Flint Ct., Macomb, MI 48044 | 2011-07-11 |
| Find all providers in zip 48044 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633062 | Urgent Care Aid Pllc | Family Medicine | 16820 21 Mile Rd, Macomb, MI 48044-2601 | 2020-06-16 |
| 1942684741 | Isabella Scofield | Family Medicine | 46591 Romeo Plank Rd Ste 200, Macomb, MI 48044 | 2015-07-13 |
| 1376792648 | Dennis Ray Samuelson | Family Medicine | 1300 W Adams St, Macomb, IL 61455-1235 | 2008-09-11 |
| 1457526428 | Farmbrooke Family Physicians PC | Family Medicine | 48924 Hayes Rd, Macomb, MI 48044-1955 | 2008-04-29 |
| 1518036979 | Richard Earl Minter | Family Medicine | 505 E Grant St Ste 202, Macomb, IL 61455-3373 | 2006-11-07 |
| 1538261912 | Richard Bruce Iverson | Family Medicine | One University Circle, Beu Health Center, Macomb, IL 61455 | 2006-09-05 |
| 1730130063 | Macomb Internists PC | Family Medicine | 46857 Garfield Rd, Macomb, MI 48044-5225 | 2006-05-12 |
| 1548226467 | Cecilly A Pratt | Family Medicine | 15959 Hall Rd Ste 104, Macomb, MI 48044 | 2006-04-21 |
| 1922098193 | Alan P Peter | Family Medicine | 16800 24 Mile Rd, Macomb, MI 48042-2990 | 2005-10-27 |
| 1053895953 | Naomi R Polley | Family Medicine | 525 E Grant St, Macomb, IL 61455-3318 | 2018-09-18 |
| Find all providers in MACOMB | ||||
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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.