DELTA RENAL GROUP, P.C.


Address: 20755 Greenfield Rd, Suite Number 203, Southfield, MI 48075-5403
Phone: 2483952206

DELTA RENAL GROUP, P.C. (NPI# 1407863194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407863194
Entity Type Organization
Organization Name DELTA RENAL GROUP, P.C.
Other Organization Name BONIFACE TUBIE, M.D.
Practice Address 20755 Greenfield Rd
Suite Number 203
Southfield
MI 48075-5403
Practice Telephone 2483952206
Practice Fax Number 2483950456
Mailing Telephone 2483952206
Mailing Fax Number 2483950456
Enumeration Date 2006-08-02
Last Update Date 2020-08-22
Authorized Official Name DR. BONIFACE ATAKEKOR TUBIE (PRESIDENT/ COE)
Authorized Official Telephone 2483952206
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RN0300X Internal Medicine
Specialization: Nephrology
4301072901 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 4341231 05

Other Provider/Organization Names

Other Name Type Code
Boniface Tubie, M.D. Doing Business As Name - Organization

Office Location

Street Address 20755 GREENFIELD RD
SUITE NUMBER 203
City SOUTHFIELD
State MI
Zip Code 48075-5403

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053310128 Laz Medical Group PC Family Medicine 20755 Greenfield Rd, #1101, Southfield, MI 48075-5403 2005-07-20
1316467319 Enlightened Medical Home Visit Pllc Clinic/Center 20755 Greenfield Rd, Suite 803, Southfield, MI 48075 2017-06-21
1245764737 Sharon Blackshire-tubie Nurse Practitioner 20755 Greenfield Rd, #203, Southfield, MI 48075-5403 2017-04-12
1487198255 Monique R Clark Nurse Practitioner 20755 Greenfield Rd, Suite 100, Southfield, MI 48075-5403 2016-12-13
1376094268 Therahealth Physio Therapy Preferred Provider Organization 20755 Greenfield Rd, Suite 602, Southfield, MI 48075-5403 2016-10-17
1528518511 Progressive Rehab Services, Inc. Clinic/Center 20755 Greenfield Rd, Ste 200, Southfield, MI 48075-5403 2016-10-13
1265982466 Uche Obua Nurse Practitioner 20755 Greenfield Rd, Southfield, MI 48075-5403 2016-10-12
1831543768 Metro Mobility, LLC Non-emergency Medical Transport (VAN) 20755 Greenfield Rd, Ste 810, Southfield, MI 48075 2016-04-18
1992183875 Mobility Home Health Care Inc Home Health 20755 Greenfield Rd, Suite 202, Southfield, MI 48075-5403 2015-05-12
1114330966 Kinetix Rehab Services, Inc. Clinic/Center 20755 Greenfield Rd, Southfield, MI 48075-5403 2014-06-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851900054 K&b Medical Wigs, LLC Durable Medical Equipment & Medical Supplies 16250 Northland Dr. Ste 221, Southfield, MI 48075 2020-07-24
1790300390 Julian Jeberaeel Radiology 2250 Providence, Southfield, MI 48075 2020-06-10
1265056410 Husein Yusuf Husein Podiatrist Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 2020-06-03
1952945420 Paris Straughter Nurse Practitioner 18438 Onyx St, Southfield, MI 48075 2019-10-29
1811467657 Medicine Man Medical, Pllc Physical Medicine & Rehabilitation 25130 Southfield Road, Suite #210, Southfield, MI 48075 2018-12-04
1447725528 Rommel Ramos Perez Physical Therapist 26017 Greenfield Rd., Southfield, MI 48075 2018-10-04
1073009627 Jacqueline Venora Goodgame Licensed Practical Nurse 4000 Town Ctr, Southfield, MI 48075 2018-07-06
1043712532 Hollie Marie Maltese Physical Therapy Assistant 22255 Greenfiled 118, Southfield, MI 48075 2018-03-01
1932601481 Katie Marie Mccormack Occupational Therapist 16001 West Nine Mile Rd., Southfield, MI 48075 2018-03-01
1801304241 Absolute Hc LLC Physical Therapist 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 2018-01-19
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285085860 Omer Yousif Internal Medicine 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 2016-06-24
1306111463 Yassir Sirajeldin Internal Medicine 22250 Providence Dr Ste 406, Southfield, MI 48075-6212 2012-03-21
1336510072 Nephro-care Md Plc Internal Medicine 23077 Greenfield Rd, Suite 479, Southfield, MI 48075-3709 2015-10-07
1942459805 Kidney Specialists of Michigan Internal Medicine 29829 Telegraph Rd, Ste 202, Southfield, MI 48034-1330 2008-09-16
1477522423 Ali Reza Ashtari Internal Medicine 22250 Providence Dr, Suite 406, Southfield, MI 48075-4825 2006-03-14
1619943180 Iram A Rehman Internal Medicine 22250 Providence Dr, Ste 406, Southfield, MI 48075 2006-02-24
1871567651 Fawaz Al-ejel Internal Medicine 22250 Providence Drive, Ste 406, Southfield, MI 48075 2006-02-16
1225009145 Nephron Associates, PC Internal Medicine 29877 Telegraph Rd, Suite 301, Southfield, MI 48034-1332 2006-01-30
1841270196 Irfan Omar Internal Medicine 29877 Telegraph Rd, Suite 400, Southfield, MI 48034-1332 2006-01-20
1558341800 Robert S Michaels Internal Medicine 29877 Telegraph Rd, Suite 301, Southfield, MI 48034-1332 2006-01-20
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Competitor

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City SOUTHFIELD
Zip Code 48075

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Dataset Information

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.

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