BROOKSIDE HEALTH CENTER, P.C. (NPI# 1437182557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437182557 |
| Entity Type | Organization |
| Organization Name | BROOKSIDE HEALTH CENTER, P.C. |
| Practice Address |
8790 Telegraph Rd Taylor MI 48180-2491 |
| Practice Telephone | 3132952520 |
| Practice Fax Number | 3135810228 |
| Mailing Telephone | 3132952520 |
| Mailing Fax Number | 3135810228 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2008-01-16 |
| Authorized Official Name | MARK B SAFFER (CEO) |
| Authorized Official Telephone | 3132912520 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3078099 | 05 | |
| MI | 4182654 | 05 | |
| MI | 4192187 | 05 | |
| MI | 4456777 | 05 | |
| MI | 4591234 | 05 | |
| MI | BCBSM | 0Q26079 | 01 |
| Street Address |
8790 TELEGRAPH RD |
| City | TAYLOR |
| State | MI |
| Zip Code | 48180-2491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407033848 | Brookside Health Center PC | Internal Medicine | 8790 Telegraph Rd, Taylor, MI 48180-2491 | 2008-01-29 |
| 1952587149 | Brookside Health Center P.C. | Podiatrist | 8790 Telegraph Rd, Taylor, MI 48180-2491 | 2008-01-17 |
| 1629274030 | Midwest Health Center-brookside | Preventive Medicine | 8790 Telegraph Rd, Taylor, MI 48180-2491 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568920288 | Kenneth Harlan | Physical Therapist | 22606 Northline Rd., Taylor, MI 48180 | 2019-03-12 |
| 1790270916 | Ryan Thomas Sankovic | Physical Medicine & Rehabilitation | 10000 Telegraph Road, Taylor, MI 48180 | 2018-06-29 |
| 1538658026 | Deborah Moseley | Physical Therapist | 21308 Eureka Rd, Taylor, MI 48180 | 2018-05-09 |
| 1366944837 | Cheryl Lee Ivie | Nurse Practitioner | 26650 Eureka Rd Suite C, Taylor, MI 48180 | 2018-03-01 |
| 1619407376 | Markesha Lynn Smith | Case Manager/Care Coordinator | 26550 Eureka Road, Suite C, Taylor, MI 48180 | 2017-06-15 |
| 1376072645 | Chris James Clark | Massage Therapist | 11178 Katrine, Taylor, MI 48180 | 2017-06-08 |
| 1245767151 | Alexandre John Mazar | Student in an Organized Health Care Education/Training Program | 10000 Telegraph Road - Beaumont Taylor Hospital, Physical Medicine and Rehabilitation Department, Taylor, MI 48180 | 2017-05-23 |
| 1063949030 | Jared David Mccallum | Physical Medicine & Rehabilitation | Beaumont Hospital, Taylor - Attn: Chris L Birkenhauer, 10000 Telegraph Ro, Taylor, MI 48180 | 2017-05-22 |
| 1972039667 | Chante Lowman | Specialist/Technologist | 23774 Crisler St., Taylor, MI 48180 | 2017-05-02 |
| 1477003036 | Latricia Osborne | Licensed Practical Nurse | 94060e. Pickwick Circle, Taylor, MI 48180 | 2016-10-07 |
| Find all providers in zip 48180 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1164051504 | Atlas Natural Medicine Pllc | General Practice | 1426 N Main St Ste 106, Taylor, TX 76574-3031 | 2020-04-07 |
| 1265876841 | Housecall Medical LLC | General Practice | 20600 Eureka Rd, Suite 709, Taylor, MI 48180-5343 | 2013-04-25 |
| 1598075566 | Taylor Medical Center LLC | General Practice | 7700 Telegraph Rd, Taylor, MI 48180-2236 | 2010-10-08 |
| 1871809442 | Mohamed Mansour .md | General Practice | 8750 Telegraph Rd, Suite 100, Taylor, MI 48180-2397 | 2010-08-20 |
| 1407003965 | Kmc Inc | General Practice | 24455 Goddard Rd, Taylor, MI 48180-3933 | 2008-08-26 |
| 1376667337 | Anil S Prasad | General Practice | 10501 Telegraph Rd, Suite #101, Taylor, MI 48180-3375 | 2007-03-16 |
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| Find all providers with the same taxonomy | ||||
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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.