CENTER FOR PREVENTIVE MEDICINE PC (NPI# 1174719025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174719025 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PREVENTIVE MEDICINE PC |
| Practice Address |
20870 Mack Ave Grosse Pointe Woods MI 48236-1388 |
| Practice Telephone | 3138852334 |
| Practice Fax Number | 3136474837 |
| Mailing Telephone | 3138852334 |
| Mailing Fax Number | 3136474837 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2017-05-04 |
| Authorized Official Name | DR. STEPHENIE LUCAS (OWNER) |
| Authorized Official Telephone | 3138852334 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
20870 MACK AVE |
| City | GROSSE POINTE WOODS |
| State | MI |
| Zip Code | 48236-1388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962931261 | Total Pain Care and Rehabilitation, Plc | Physical Medicine & Rehabilitation | 20870 Mack Ave, Grosse Pointe Woods, MI 48236-1388 | 2017-06-08 |
| 1093259996 | Christina Oney | Psychologist | 20870 Mack Ave, Grosse Pointe Woods, MI 48236-1388 | 2016-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1861928681 | George Brian Gennaoui | Internal Medicine | 19251 Mack Ave Ste 340, Grosse Pointe Woods, MI 48236-2891 | 2017-05-11 |
| 1679933956 | Laura Kohler | Internal Medicine | 19229 Mack Ave. Suite 34, Grosse Pointe Woods, MI 48236 | 2016-03-01 |
| 1407232184 | Sindhu Janarthanam Malapati | Internal Medicine | 19229 Mack Ave Ste 34, Grosse Pointe Woods, MI 48236-2857 | 2015-08-05 |
| 1235396656 | George Peter Kypros | Internal Medicine | 544 S Rosedale Ct, Grosse Pointe Woods, MI 48236-1145 | 2008-05-22 |
| 1275644601 | Catherine S Sonaglia | Internal Medicine | 19557 Mack Ave, Ste B, Grosse Pointe Woods, MI 48236-2859 | 2006-08-31 |
| 1356334270 | Mohammed K Beeai | Internal Medicine | 19251 Mack Ave, Grosse Pointe Woods, MI 48236-2893 | 2005-08-25 |
| 1841726965 | Zachary Aaron Pounders | Internal Medicine | 19229 Mack Ave Ste 34, Grosse Pointe Woods, MI 48236-2857 | 2017-05-10 |
| 1780033555 | Safa Maki | Internal Medicine | 19251 Mack Ave Ste 333, Grosse Pointe Woods, MI 48236-2898 | 2016-06-12 |
| 1285041905 | Aditi Singh | Internal Medicine | 19229 Mack Ave Ste 23, Grosse Pointe Woods, MI 48236-2857 | 2014-07-15 |
| 1619228483 | Hosam Hakim | Internal Medicine | 19229 Mack Ave Ste 24, Grosse Pointe Woods, MI 48236-2857 | 2012-09-20 |
| Find all providers in GROSSE POINTE WOODS | ||||
| City | GROSSE POINTE WOODS |
| Zip Code | 48236 |
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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.