DR. BRIAN KEVIN THEISEN (NPI# 1407246226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407246226 |
| Entity Type | Individual |
| Full Name | DR. BRIAN KEVIN THEISEN |
| Credential | M.D. |
| Practice Address |
2799 W Grand Blvd Detroit MI 48202-2608 |
| Practice Telephone | 3139162964 |
| Enumeration Date | 2015-02-01 |
| Last Update Date | 2020-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
MD045329 | DC | Allopathic & Osteopathic Physicians |
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
4301501908 | MI | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MD045329 | DC | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
4301501908 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2120 L St Nw, Washington, DC 200371527 | 2027154665 | |
| 3550 Terrace St, A711 Scaife Hall, Pittsburgh, PA 152132500 | 4128026013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912265455 | Brian James Theisen | Physical Therapist | 8100 Northland Dr, Minneapolis, MN 55431-4800 | 2012-05-02 |
| Street Address |
2799 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132069 | Donna Prince | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2005-05-24 |
| 1790386704 | Alexandria L Blevins | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-05 |
| 1255932430 | Amy Katlyn Carion | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-04 | |
| 1871194415 | Alexandria Denise Roberts | Physical Therapist | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-11-02 |
| 1174121420 | John Charles Sanno | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-10-09 |
| 1932706991 | Fallon J Awe | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-02 |
| 1922615145 | Chelsea Elizabeth Owen | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1275130395 | Zana Latkovac | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1487260030 | Jessica Lee Moret | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-18 |
| 1932713237 | Lucas Costa Santos | Anesthesiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1144636895 | Ramya Gadde | Pathology | 2799 W.grand Boulevard,henry Ford Hospital, Detroit, MI 48202-2608 | 2014-07-02 |
| 1316202997 | Umer Nisar Sheikh | Pathology | 22101 Moross Rd # Ccb-sb, St. John Hospital & Medical Center, Dept of Pathology, Detroit, MI 48236-2148 | 2012-07-10 |
| 1053521799 | Jyotinder Nain Punia | Pathology | Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202-2608 | 2007-05-23 |
| 1093924466 | Kewang Li | Pathology | 4500 Cass Ave, Apt#1010, Detroit, MI 48201-1288 | 2007-05-22 |
| 1760422638 | John D Crissman | Pathology | 9374 Scott Hall 540 E Canfield Ave, Wayne State University School of Medicine, Detroit, MI 48201-1928 | 2006-06-07 |
| 1336187061 | Lucia A Schuger | Pathology | Detroit Receiving Hospital Pathology, 4201 St Antoine Ste 3e, Detroit, MI 48201 | 2006-06-03 |
| 1992743017 | Husain A Saleh | Pathology | Sinai Grace Hospital Pathology, 6071 W Outer Dr, Detroit, MI 48235 | 2006-06-02 |
| 1851338842 | Shashi K Madan | Pathology | Harper Hospital Pathology, 3990 John R, Detroit, MI 48201-2097 | 2006-05-31 |
| 1205873296 | Raj Dulari Bhan | Pathology | Hutzel Hospital Pathology, 4707 St Antoine, Detroit, MI 48201 | 2006-05-31 |
| Find all providers in DETROIT | ||||
Please comment or provide details below to improve the information on DR. BRIAN KEVIN THEISEN.
| 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.