METRO DETROIT RENAL DOCTOR (NPI# 1417230889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417230889 |
| Entity Type | Organization |
| Organization Name | METRO DETROIT RENAL DOCTOR |
| Practice Address |
21331 Kelly Rd Suite 120 Eastpointe MI 48021-3265 |
| Practice Telephone | 5867777620 |
| Practice Fax Number | 5865859947 |
| Mailing Telephone | 5867777620 |
| Mailing Fax Number | 5865859947 |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |
| Authorized Official Name | DR. RAKESH LATTUPALLI (NEPHROLOGY) |
| Authorized Official Telephone | 5867777620 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
21331 KELLY RD SUITE 120 |
| City | EASTPOINTE |
| State | MI |
| Zip Code | 48021-3265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841292158 | Rakesh Lattupalli | Internal Medicine | 21331 Kelly Rd, Ste. 120, Eastpointe, MI 48021-3265 | 2005-06-01 |
| 1710336995 | Massage Matters Michigan LLC | Public Health or Welfare | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2016-06-08 |
| 1144677915 | Sheritta Marie Buford | Specialist | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2016-05-20 |
| 1992139562 | Physical Rehab Services LLC | Clinic/Center | 21331 Kelly Rd, Ste 140a, Eastpointe, MI 48021 | 2013-08-30 |
| 1659698884 | Administrative Specialists, LLC | Family Medicine | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2010-04-28 |
| 1912224148 | Primary Care Physicians Iv, P.C. | Family Medicine | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2010-04-28 |
| 1174840417 | Richard S Fine Md PC | Internal Medicine | 21331 Kelly Rd, Suite 100, Eastpointe, MI 48021-3265 | 2010-04-27 |
| 1891955597 | Kenneth Dziuba Md PC | Internal Medicine | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2008-06-16 |
| 1205093275 | Primary Care Physicians II, P.C. | Specialist | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2008-05-19 |
| 1376566596 | Richard Sherman Fine | Internal Medicine | 21331 Kelly Rd, Ste 100, Eastpointe, MI 48021 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588137483 | Beautiful Tomorrow Inc | Home Health | 22430 Gratiot Ave., Eastpointe, MI 48021 | 2019-01-03 |
| 1760922553 | Urgent Care Plus, PC | Clinic/Center | 16184 E 10 Mile Rd Ste 102, Eastpointe, MI 48021 | 2017-02-28 |
| 1295187961 | Danielle Wansley | Licensed Practical Nurse | 24934 Rawen Ave, Eastpointe, MI 48021 | 2016-07-06 |
| 1548615966 | Unique Burton | Licensed Practical Nurse | 15025 Charles, Eastpointe, MI 48021 | 2016-05-04 |
| 1376908707 | Dalinda Richardson | Physical Therapist | 18200 E Tenmile Road, 200, Eastpointe, MI 48021 | 2015-12-30 |
| 1780050369 | Russell Marcilis II | Prosthetic/Orthotic Supplier | 18121 E. 8 Mile Ste 100, Eastpointe, MI 48021 | 2015-08-18 |
| 1841603594 | Charlotte Loraine Kroll | Dentist | 24541 Gratiot Ave., Eastpointe, MI 48021 | 2014-06-10 |
| 1114357720 | Zuri Tanay Boyd-mcgarrity | Social Worker | 4160 Woodward, 2nd Floor, Detroit, MI 48021 | 2013-11-18 |
| 1619219888 | Bettye Ruth Edwards | Social Worker | 23721 Kelly # 7, Eas Pointe, MI 48021 | 2013-03-26 |
| 1578807392 | Angela Marie Travis | Specialist | 21062 Kelly Road, Eastpoint, MI 48021 | 2012-11-16 |
| Find all providers in zip 48021 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841292158 | Rakesh Lattupalli | Internal Medicine | 21331 Kelly Rd, Ste. 120, Eastpointe, MI 48021-3265 | 2005-06-01 |
| 1366535130 | Hassan Fehmi | Internal Medicine | Henry Ford Health System, 21400 Kelly Road, Eastpointe, MI 48021 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440439 | Nephrocare Dialysis, LLC | Internal Medicine | Garden City Hosptial, 6245 Inkster Road, Garden City, MI 48135 | 2020-02-25 |
| 1740823459 | Critical Care Nephrology, PC | Internal Medicine | 333 E Parent Ave, Royal Oak, MI 48067-3748 | 2019-10-25 |
| 1568948537 | Amanda Thelen | Internal Medicine | 405 W Greenlawn Ave Ste 230, Lansing, MI 48910-0812 | 2018-07-12 |
| 1023507357 | James Francis Murphy | Internal Medicine | Hope Medical Clinic 518 Harriet St., Ypsilanti, MI 48197-0311 | 2018-05-02 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1982129805 | Abhay Mishra | Internal Medicine | 4160 John R St Ste 908, Detroit, MI 48201-2017 | 2017-08-11 |
| 1326586959 | Alhaji Consultant Pllc | Internal Medicine | 29201 Chateau Ct, Farmington Hills, MI 48334-4112 | 2017-02-02 |
| 1033669445 | T-beyene Hypertension & Kidney Care Plc | Internal Medicine | 4160 John R Ste 1011, Harper Professional Building, Detroit, MI 48201 | 2016-10-10 |
| 1285085860 | Omer Yousif | Internal Medicine | 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 | 2016-06-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
| City | EASTPOINTE |
| Zip Code | 48021 |
Please comment or provide details below to improve the information on METRO DETROIT RENAL DOCTOR.
| 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.