DR. JURIN BORIBOON (NPI# 1336198142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336198142 |
| Entity Type | Individual |
| Full Name | DR. JURIN BORIBOON |
| Credential | M.D. |
| Practice Address |
15350 Trenton Rd Southgate MI 48195-2027 |
| Mailing Address |
17421 Parke Ln Grosse Ile MI 48138-1043 |
| Practice Telephone | 7342834616 |
| Practice Fax Number | 7342835430 |
| Mailing Telephone | 7342834616 |
| Mailing Fax Number | 7342835430 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301031535 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1234470 | 05 |
| Street Address |
15350 TRENTON RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669448783 | Khalid Kamal | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-02-28 |
| 1124594288 | Christina M Ralko | Nurse Practitioner | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2018-10-16 |
| 1154559177 | Jason William Bihn | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2009-06-29 |
| 1871796706 | Saba Raisa Cossor | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2007-06-07 |
| 1952498875 | Child and Adolescent Center P C | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-10-10 |
| 1861425720 | Ahmad Ammar Mourad | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-07-07 |
| 1962469866 | Yong S Kim | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-04-26 |
| 1598721722 | Petronio C Yadao | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790839819 | James John Otrembiak | Pediatrics | 525 Alexandria Pike Ste 320, Southgate, KY 41071 | 2007-01-23 |
| 1902979495 | Jerald Purifoy | Pediatrics | 15777 Northline Rd Ste 203, Southgate, MI 48195-2354 | 2006-11-15 |
| 1568430502 | Dinesh Nayak | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2006-03-08 |
| 1669448783 | Khalid Kamal | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2006-02-28 |
| 1386186930 | Brenden Bisson | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2016-11-14 |
| 1154559177 | Jason William Bihn | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2009-06-29 |
| 1770779589 | Zeeshan Tarique | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2007-09-15 |
| 1871796706 | Saba Raisa Cossor | Pediatrics | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2007-06-07 |
| 1235284233 | Dr. Dinesh Nayak, Md, P.C. | Pediatrics | 15255 Northline Rd, Southgate, MI 48195-2487 | 2007-01-23 |
| 1457410912 | Shakeeb Chinoy | Pediatrics | 15255 Northline Rd, Southgate, MI 48195-2487 | 2006-12-08 |
| Find all providers in SOUTHGATE | ||||
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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.