JEANETTE ELIZABETH WILSON (NPI# 1376926865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376926865 |
| Entity Type | Individual |
| Full Name | JEANETTE ELIZABETH WILSON |
| Credential | M.D. |
| Practice Address |
21099 Masonic Blvd Saint Clair Shores MI 48082 |
| Mailing Address |
21099 Masonic Blvd Saint Clair Shores MI 48082-1045 |
| Practice Telephone | 5862966213 |
| Mailing Telephone | 5867772050 |
| Mailing Fax Number | 5862966213 |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301108210 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301108210 | MI | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 24911 Little Mack Ave, Suite C, Saint Clair Shores, MI 480803200 | 5867772050 | 5867772189 |
| Street Address |
21099 MASONIC BLVD |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376503151 | Rachel Eileen O'byrne | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-03-24 |
| 1649708959 | Hany Eraqi | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2017-05-31 |
| 1386892834 | St. John Hospital and Medical Center | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2008-09-08 |
| 1841470481 | Kwame O. Francis | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2007-11-12 |
| 1467571463 | Veena Panthangi | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2007-03-29 |
| 1699725481 | Barry Joseph Scofield | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-05-11 |
| 1306895065 | Chandrika Iyer | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932416476 | Maryam Torab Parhiz | Dentist | 31118 Harper Ave, St.clair Shores, MI 48082 | 2010-09-03 |
| 1558519314 | Sandra J. Glovak | Occupational Therapist | 30801 Jefferson Ave., St. Clair Shores, MI 48082 | 2008-09-05 |
| 1750597498 | Philip Salvatore Badalamenti | Dentist | 29810 Harper Ave, St Clair Shores, MI 48082 | 2007-05-16 |
| 1710025499 | Camilo Machado | Dentist | 31315 Harper Avenuw, St. Clair Shores, MI 48082 | 2007-02-02 |
| 1427126457 | Daniel M Hull | Dentist | 31549 Harper, Saint Clair Shores, MI 48082 | 2006-11-30 |
| 1679662860 | Peter Leone | Dentist | 30140 Harper Ave, Suite 200, Saint Clair Shores, MI 48082 | 2006-10-12 |
| 1417063371 | Vincent James Alongi | Dentist | 30140 Harper Suite 100, St Clair Shores, MI 48082 | 2006-08-22 |
| 1598721060 | Ilse Karger | Dentist | 29850 Harper, St Clair Shores, MI 48082 | 2006-04-25 |
| 1093714081 | Brian Anthony Arnold | Chiropractor | 31930 Harper Ave, Saint Clair Shores, MI 48082 | 2005-07-20 |
| 1619469905 | Bryan Lazzarin | Optometrist | 30120 Harper Ave, Saint Clair Shores, MI 48082 | 2018-06-01 |
| Find all providers in zip 48082 | ||||
| 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 |
|---|---|---|---|---|
| 1750818118 | Dayna E Snyder | Family Medicine | 20225 E 9 Mile Rd Ste 100a, Saint Clair Shores, MI 48080-1700 | 2017-05-16 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1407161086 | Audrey M Sim Pllc | Family Medicine | 25915 Harper Ave Ste B, Saint Clair Shores, MI 48081-3770 | 2010-08-08 |
| 1083875702 | Mark B Alrais | Family Medicine | 21600 Harper Ave Ste 100, Saint Clair Shores, MI 48080-2242 | 2008-06-25 |
| 1245327691 | Naira S. Henein | Family Medicine | 21510 Harper Ave, Saint Clair Shores, MI 48080-2211 | 2006-10-06 |
| 1154437416 | Carolyn Emily Nine | Family Medicine | 22646 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080-1951 | 2006-08-21 |
| 1124049705 | Carey Marie Vigor | Family Medicine | 24001 Greater Mack Ave Ste A, Saint Clair Shores, MI 48080-1471 | 2006-07-21 |
| 1376503151 | Rachel Eileen O'byrne | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-03-24 |
| 1407822612 | Laurie Jean Rudnick | Family Medicine | 19901 E 10 Mile Rd, Saint Clair Shores, MI 48080-1069 | 2006-02-27 |
| 1275525966 | Sigmund O Mcintyre | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2005-08-18 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48082 |
Please comment or provide details below to improve the information on JEANETTE ELIZABETH WILSON.
| 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.