DR. DOUGLAS JOSEPH GARDNER (NPI# 1205872694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205872694 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS JOSEPH GARDNER |
| Credential | MD |
| Practice Address |
4491 Venoy Rd Wayne MI 48184-2530 |
| Practice Telephone | 7343265030 |
| Mailing Telephone | 7343265030 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301063486 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4706118 | 05 | |
| MI | 4706127 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548200462 | Douglas Edward Gardner | Social Worker | 37634 Enterprise Ct, Farmington Hills, MI 48331-3440 | 2006-06-08 |
| 1659998730 | Douglas Scott Gardner | Dentist | 324 W 2nd St, Seymour, IN 47274-2199 | 2020-07-06 |
| 1356637524 | Douglas Edward Gardner | Pharmacist | 465 Stateline Rd W, Southaven, MS 38671-1611 | 2011-06-25 |
| 1770650798 | Douglas A. Gardner | Internal Medicine | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2006-11-29 |
| Street Address |
4491 VENOY RD |
| City | WAYNE |
| State | MI |
| Zip Code | 48184-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164607040 | Se Radiology Associates, PC | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2008-01-09 |
| 1689607426 | Erika Shannon Luster | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-07 |
| 1831122746 | Sneh Gupta | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-07 |
| 1750310397 | Cheryl Grigorian | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-03 |
| 1184653735 | Sherif Salaheldene Ibrahim | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-03 |
| 1770513137 | Venkat Chinna Rudraraju | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-03 |
| 1497784284 | Saleem Azad | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-07-02 |
| 1366478513 | Alkis P Zingas | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-06-22 |
| 1154357317 | Shameem Menon | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570932 | Wayne Rx | Pharmacy | 4603 Wayne Rd, Wayne, MI 48184 | 2019-10-25 |
| 1669902433 | Randi Oswald | Massage Therapist | 34336 Richard St., Wayne, MI 48184 | 2017-06-14 |
| 1306393822 | Amanda Anastasoff | Technician, Other | 35640 West Michigan Avenue, Wayne, MI 48184 | 2016-09-01 |
| 1871941302 | Christopher Schrimscher | Technician, Other | 34560 Michigan Avenue W, Wayne, MI 48184 | 2016-05-25 |
| 1659757334 | Anna Bondy | Technician, Other | 35640 Michigan Ave. West, Wayne, MI 48184 | 2015-08-05 |
| 1992184550 | Carrie Walrath | Community Health Worker | 4234 Niagara, Wayne, MI 48184 | 2015-05-28 |
| 1588043459 | Suzanne Cutlip | Case Manager/Care Coordinator | 35425 Michigan Ave. W. Suite 1, Wayne, MI 48184 | 2015-05-26 |
| 1285021295 | Alicia Allen | Technician, Other | 35640 Michigan Avenue West, Wayne, MI 48184 | 2015-04-17 |
| 1164843850 | Julia Krivoy | Nurse Anesthetist, Certified Registered | 33155 Annapolis St., Beaumont/oakwood Hospital - Wayne, Wayne, MI 48184 | 2013-12-23 |
| 1992130553 | One Stop Pharmacy LLC | Pharmacy | 33950 Van Born Rd, Wayne, MI 48184 | 2013-09-13 |
| Find all providers in zip 48184 | ||||
| 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 |
|---|---|---|---|---|
| 1902080443 | Richard B. Keohane | Radiology | 20 Fariston Rd, Wayne, PA 19087-3415 | 2007-12-19 |
| 1366500530 | Vita Medical Center, PC | Radiology | 87 Berdan Ave Ste 2b, Wayne, NJ 07470-3210 | 2006-12-04 |
| 1326078668 | S E Radiology Associates PC | Radiology | 33155 Annapolis Way, Wayne, MI 48184-2405 | 2006-07-03 |
| 1871578930 | Faith Ann Farley | Radiology | 201 S Aberdeen Ave, Wayne, PA 19087-4801 | 2005-12-13 |
| 1710971791 | Imaging Associates Pa | Radiology | 1350 Rte 23, Mrimaging of Wayne, Wayne, NJ 07470-5839 | 2005-09-07 |
| 1740599042 | Dwf Imaging LLC | Radiology | 87 Berdan Ave, Suite 2b, Wayne, NJ 07470-3210 | 2010-10-04 |
| 1881847192 | Wayne Valley Imaging | Radiology | 504 Valley Rd, Wayne, NJ 07470-3534 | 2008-10-30 |
| 1164607040 | Se Radiology Associates, PC | Radiology | 4491 Venoy Rd, Wayne, MI 48184-2530 | 2008-01-09 |
| 1922169929 | High Mountain Radiology | Radiology | 468 Parish Dr, Suite 6, Wayne, NJ 07470-4671 | 2006-12-13 |
| 1124111364 | Jin Young Hur | Radiology | 330 Ratzer Road, Wayne, NJ 07470 | 2006-10-02 |
| Find all providers in WAYNE | ||||
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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.