LATHA SREE POLAVARAM (NPI# 1194934802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194934802 |
| Entity Type | Individual |
| Full Name | LATHA SREE POLAVARAM |
| Credential | MD |
| Practice Address |
145 Michigan St Ne Ste 3100 Grand Rapids MI 49503-2563 |
| Mailing Address |
5800 Foremost Dr Se Ste 300 Grand Rapids MI 49546-7062 |
| Practice Telephone | 6169549800 |
| Practice Fax Number | 6169542116 |
| Mailing Telephone | 6169549800 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
4301083922 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
145 MICHIGAN ST NE STE 3100 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-2563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639179286 | Thomas E Gribbin | Internal Medicine | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2005-07-26 |
| 1225637325 | Margaret E Tol | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2020-10-20 |
| 1952908279 | Pauline U Boy | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2020-10-09 |
| 1285270157 | Heather Ozinga | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2019-11-26 |
| 1427616580 | Samantha Burgess | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2019-06-04 |
| 1952966111 | Lisa Marie Teunissen | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2019-05-03 |
| 1649743766 | Kaitlin Derks | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2019-01-11 |
| 1679042733 | Natalie Mccarty | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2018-11-19 |
| 1144701228 | Miranda Iacopelli | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2018-08-27 |
| 1285120287 | Karole Lynn Murphy | Nurse Practitioner | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2018-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154585172 | Kenneth A Krajewski | Internal Medicine | 1534 Groton Rd Se, Grand Rapids, MI 49506-4754 | 2008-07-18 |
| 1568641074 | Frances Ying-nok Wong | Internal Medicine | 5800 Foremost Dr Se Ste 200, Grand Rapids, MI 49546-7062 | 2007-10-31 |
| 1790727360 | Anas Al-janadi | Internal Medicine | 145 Michigan St Ne Ste 5200, Grand Rapids, MI 49503-2565 | 2006-06-11 |
| 1639179286 | Thomas E Gribbin | Internal Medicine | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2005-07-26 |
| 1003235391 | Andrew Leo Sochacki | Internal Medicine | 5800 Foremost Dr Se Ste 200, Grand Rapids, MI 49546-7062 | 2014-04-15 |
| 1952720906 | Haritha Ganesh Reddy | Internal Medicine | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2014-04-07 |
| 1952677031 | Erin Lee Schwab | Internal Medicine | 250 Cherry St Se Ste 2200, Grand Rapids, MI 49503-4608 | 2012-03-22 |
| 1003101429 | Erin Megan Pettijohn | Internal Medicine | 250 Cherry St Se Ste 2200, Grand Rapids, MI 49503-4608 | 2011-06-14 |
| 1174700256 | Eric C. Santos | Internal Medicine | 145 Michigan St Ne, Suite 3100, Grand Rapids, MI 49503-2562 | 2008-01-30 |
| 1972705838 | Sreenivasa Chandana | Internal Medicine | 145 Michigan St Ne Ste 3100, Grand Rapids, MI 49503-2563 | 2007-06-04 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on LATHA SREE POLAVARAM.
| 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.