VITAL MEDICAL GROUP PC (NPI# 1316564560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316564560 |
| Entity Type | Organization |
| Organization Name | VITAL MEDICAL GROUP PC |
| Practice Address |
35 S Johnson St Ste 1b Pontiac MI 48341-1660 |
| Practice Telephone | 3134638676 |
| Mailing Telephone | 3134638676 |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | HERBERT ISSAC (OWNER) |
| Authorized Official Telephone | 3134638676 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
35 S JOHNSON ST STE 1B |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962062539 | Healthcare Alliance Pllc | General Practice | 35 S Johnson St Ste 1b, Pontiac, MI 48341-1660 | 2019-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649813650 | Metro Med Pain Management & Rehab Plc | Clinic/Center | 4520 Firestone St Ste A, Dearborn, MI 48126-4602 | 2019-10-22 |
| 1295382976 | Care Recovery Clinic Pllc | Clinic/Center | 13530 Michigan Ave Ste 301, Dearborn, MI 48126-3555 | 2019-08-19 |
| 1902459860 | Comprehensive Care Pain Management, P.C. | Clinic/Center | 9001 15 Mile Rd Ste C, Sterling Heights, MI 48312-3621 | 2019-07-19 |
| 1386296077 | Michigan Institute of Musculoskeletal Medicine Pllc | Clinic/Center | 26206 W 12 Mile Rd Ste 200, Southfield, MI 48034-8500 | 2019-07-12 |
| 1740832930 | Heights Pain Management & Rehab Plc | Clinic/Center | 30671 Stephenson Hwy Ste D, Madison Heights, MI 48071-1635 | 2019-07-09 |
| 1609340215 | Michigan Orthopedic Spine & Interventionalist Pllc | Clinic/Center | 17290 Stonebrook Dr, Northville, MI 48168-4324 | 2019-01-16 |
| 1992204341 | Jawad A Shah Md PC | Clinic/Center | 4400 S Saginaw St Ste 1370, Flint, MI 48507-2668 | 2018-02-12 |
| 1508308750 | Mark Sobor, Md | Clinic/Center | 13560 76th St, Unit 2, South Haven, MI 49090-9483 | 2016-11-04 |
| 1316316771 | Advanced Rehab and Pain Management PC | Clinic/Center | 1820 Oak Ave, Muskegon, MI 49442-2408 | 2015-09-16 |
| 1154717106 | Excellent Pain Consultants | Clinic/Center | 15565 Northland Dr W Ste 304, Southfield, MI 48075-5313 | 2015-04-07 |
| Find all providers with the same taxonomy | ||||
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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.