KELLEY BROSSY DO PC (NPI# 1316468275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316468275 |
| Entity Type | Organization |
| Organization Name | KELLEY BROSSY DO PC |
| Practice Address |
21031 Michigan Ave Dearborn MI 48124-2339 |
| Practice Telephone | (313) 277-6700 |
| Practice Fax Number | 3132160176 |
| Mailing Telephone | 3132776700 |
| Mailing Fax Number | 3132160176 |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2017-06-30 |
| Authorized Official Name | TRICIA L ADAMEN (PRACTICE MANAGER) |
| Authorized Official Telephone | 3132776700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
5315073051 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
21031 MICHIGAN AVE |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427020098 | Marc J Milia | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2006-02-07 |
| 1114542776 | David Sosnoski Jr. | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2020-06-10 |
| 1295350718 | Jacob Shermetaro | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2020-06-10 |
| 1013471846 | Great Lakes Reading, Pllc | Specialist/Technologist, Other | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2019-01-25 |
| 1528590635 | Mohamed Saad Md PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2017-03-29 |
| 1598110348 | Michigan Orthopedic Specialists, PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2016-04-29 |
| 1295193415 | Saad-waterworks, PC | Orthopaedic Surgery | 21031 Michigan Ave, Floor 2, Dearborn, MI 48124-2339 | 2016-02-02 |
| 1134587546 | Sarah Broeker | Physician Assistant | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2016-02-01 |
| 1194116947 | Rakesh Ramakrishnan Md PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2015-02-16 |
| 1013325828 | Brian Jeffrey Vosko | Physician Assistant | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2014-07-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437339025 | Michigan Orthopaedic Trauma Specialists PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2007-11-12 |
| 1568567006 | Alfred M Faulkner Do PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255704268 | Pelvis and Acetabulum Surgical Specialists, Pllc | Orthopaedic Surgery | 50297 Drakes Bay Dr, Novi, MI 48374-2544 | 2015-11-12 |
| 1689669178 | James Robert Weir | Orthopaedic Surgery | 800 Cooper Ave., Suite 12, Saginaw, MI 48602-5394 | 2005-09-12 |
| 1760481782 | Geoffrey A Sandman | Orthopaedic Surgery | 350 Lafayette Ave Se, 4th Floor, Grand Rapids, MI 49503-4656 | 2005-07-20 |
| 1215930490 | Family Orthopedic Associates P L C | Orthopaedic Surgery | 4466 W Bristol Rd, Flint, MI 48507-3170 | 2005-05-23 |
| 1417469453 | Sjmhs Livingston Orthopedic Surgical Group | Orthopaedic Surgery | 5315 Elliot Dr, Suite 304, Ypsilanti, MI 48197 | 2017-10-31 |
| 1336531730 | Ryan Bray | Orthopaedic Surgery | 311 Mack Ave Fl 5, Detroit, MI 48201-2466 | 2015-02-23 |
| 1669801411 | Moc Trauma, PC | Orthopaedic Surgery | 2815 S Pennsylvania Ave, Suite 204, Lansing, MI 48910-3495 | 2013-11-02 |
| 1356671051 | Gregory P. Nowinski Md PC | Orthopaedic Surgery | 1350 Kirts Blvd, Suite 160, Troy, MI 48084-4851 | 2010-01-04 |
| 1457581183 | Orthopedic Trauma Specialist Pllc | Orthopaedic Surgery | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2009-07-15 |
| 1477729028 | Patrick J Wiater Md,pllc | Orthopaedic Surgery | 17877 W Fourteen Mile Rd, Beverly Hills, MI 48025 | 2008-05-05 |
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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.