BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES (NPI# 1215446646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215446646 |
| Entity Type | Organization |
| Organization Name | BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES |
| Practice Address |
3601 W 13 Mile Rd Royal Oak MI 48073-6712 |
| Mailing Address |
26901 Beaumont Boulevard Southfield MI 48033-3849 |
| Practice Telephone | 2488985000 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2020-04-07 |
| Authorized Official Name | JONATHAN SCOTT MANER (SR. VP BEAUMONT PHYSICIAN PARTNERS) |
| Authorized Official Telephone | 9475221912 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
3601 W 13 MILE RD |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437155538 | Cheryl A Grain | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2005-06-23 |
| 1023617735 | Kevin Wilson Curtis | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-22 |
| 1164020939 | Chelsea Cloke | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-14 |
| 1073111258 | Jaimie Danno | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-11 |
| 1447857883 | Pamela Ann Boyd | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-08 |
| 1528675618 | Riya Kaur Kalra | Pediatrics | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-23 |
| 1174139612 | Kostiantyn Romaniv | Internal Medicine | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-21 |
| 1538775325 | Adam L Hardy | Occupational Therapist | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-17 |
| 1164038964 | Patricia W Choi | Pharmacy | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-17 |
| 1598377004 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| 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 |
|---|---|---|---|---|
| 1609306273 | Samantha Rene Cowing | Family Medicine | 309 E 11 Mile Rd, Royal Oak, MI 48067-2735 | 2017-06-15 |
| 1457889370 | Alvin John Ramos Vargas | Family Medicine | 3601 W 13 Mile Rd Ofc, Royal Oak, MI 48073-6712 | 2017-05-23 |
| 1649614470 | Kristopher Jon-amor Patnugot | Family Medicine | 1223 S Washington Ave, Royal Oak, MI 48067-3221 | 2013-04-23 |
| 1275736936 | Victor Samir Faris | Family Medicine | 1010 N Campbell Rd, Suite #3, Royal Oak, MI 48067-1570 | 2007-06-08 |
| 1558440628 | Kim Ford Kezlarian | Family Medicine | 26300 Woodward Ave, Royal Oak, MI 48067-0917 | 2006-11-02 |
| 1790767374 | Julie E Mariotti | Family Medicine | 2709 W Webster Rd, Royal Oak, MI 48073-3700 | 2005-11-18 |
| 1043200256 | Megan C Zawaideh | Family Medicine | 1041 S Main St, Royal Oak, MI 48067-3274 | 2005-10-27 |
| 1528057270 | Vincent J Granowicz | Family Medicine | 30701 Woodward Ave, Suite 314, Royal Oak, MI 48073-0987 | 2005-10-17 |
| 1457843104 | Center for Healing | Family Medicine | 720 E 11 Mile Rd, Royal Oak, MI 48067-1964 | 2018-05-30 |
| 1427578293 | Anthony Pietro Brooks | Family Medicine | 309 E 11 Mile Rd, Royal Oak, MI 48067-2735 | 2017-06-22 |
| Find all providers in ROYAL OAK | ||||
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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.