OAKLAND GASTROENTEROLOGY ASSOCIATES, P.C. (NPI# 1508964511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508964511 |
| Entity Type | Organization |
| Organization Name | OAKLAND GASTROENTEROLOGY ASSOCIATES, P.C. |
| Practice Address |
3535 W 13 Mile Rd Suite 202 Royal Oak MI 48073-6770 |
| Practice Telephone | 2485510900 |
| Practice Fax Number | 2485510905 |
| Mailing Telephone | 2485510900 |
| Mailing Fax Number | 2485510905 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-05-05 |
| Authorized Official Name | DR. GREGG POLIDORI (PRESIDENT) |
| Authorized Official Telephone | 2485510900 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
4301044285 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4257370 | 05 | |
| MI | 4101048 | 05 | |
| MI | 4340940 | 05 | |
| MI | 4310182 | 05 | |
| MI | 3364901 | 05 | |
| MI | 4318636 | 05 | |
| MI | 2836230 | 05 | |
| MI | 4340978 | 05 | |
| MI | 4258298 | 05 | |
| MI | 4592984 | 05 | |
| MI | BCBS AND BCN | 100F37143 | 01 |
| MI | 2836211 | 05 | |
| MI | 4257380 | 05 |
| Street Address |
3535 W 13 MILE RD SUITE 202 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750376877 | M Bassem Hosein Dekelbab | Pediatrics | 3535 W 13 Mile Rd, 707, Royal Oak, MI 48073-6770 | 2005-09-14 |
| 1639788029 | Moyosoreoluwa Morenike Laditan | Internal Medicine | 3535 W 13 Mile Rd, Medical Office Building, Suite Ll-35, Royal Oak, MI 48073-6770 | 2020-07-30 |
| 1952928780 | Julie Katia Morin-major | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-06-27 |
| 1336763382 | Reem Wassef | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-05 |
| 1942824271 | Ji Won Lee | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-06-02 |
| 1285257030 | Michael Maiden | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-27 |
| 1821611922 | Maria Kathryn Souphis | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-22 |
| 1710509393 | Yoshiko Nito | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-18 |
| 1699397547 | Ashbina Pokharel | Internal Medicine | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-14 |
| 1720609746 | Geoffrey M Saham Pllc | Internal Medicine | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1003128695 | Vinayata Manuballa Kareti | Internal Medicine | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2010-07-12 |
| 1043365794 | Laith Hikmet Jamil | Internal Medicine | 3535 W 13 Mile Rd Ste 248, Royal Oak, MI 48073-6770 | 2007-01-24 |
| 1386693505 | William Beauont Hospital | Internal Medicine | 3601 W 13 Mile Rd, 400 Fsc PCs, Royal Oak, MI 48073-6712 | 2006-05-06 |
| 1891755856 | Mitchell Cappell | Internal Medicine | 3535 W 13 Mile Rd, Suite 302, Royal Oak, MI 48073-6770 | 2006-03-24 |
| 1689665465 | Gregg Polidori | Internal Medicine | 3535 W 13 Mile Rd, Ste 202, Royal Oak, MI 48073-6770 | 2005-11-02 |
| 1740271527 | Tusar K Desai | Internal Medicine | 3535 W 13 Mile Rd, Ste 202, Royal Oak, MI 48073-6770 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043785561 | Digestive Health Clinic | Internal Medicine | 2486 Nerredia St Ste A, Flint, MI 48532-4807 | 2018-10-11 |
| 1053808550 | Dr. Allison Wood, Do Mph, Pllc | Internal Medicine | 4136 Legacy Pkwy Ste 100, Lansing, MI 48911-4293 | 2018-04-19 |
| 1346698784 | Spectrum Health Primary Care Partners | Internal Medicine | 2009 Holton Road, Muskegon, MI 49445 | 2016-05-26 |
| 1043698988 | Krishna Chaitanya Meka | Internal Medicine | 27301 Dequindre Rd Ste 314, Madison Heights, MI 48071 | 2015-05-12 |
| 1609260892 | Chia-yang Hsu | Internal Medicine | A. Alfred Taubman Health Care Center, 1500 East Medical Center Drive Room 3912, Ann Arbor, MI 48109 | 2015-03-25 |
| 1982015228 | Access Family Gastroenterology Pllc | Internal Medicine | G-1125 Linden Rd, Suite 500, Flint, MI 48532 | 2014-05-08 |
| 1740610401 | Gastrofit Pllc | Internal Medicine | 23500 Park St Ste 2b, Dearborn, MI 48124-2598 | 2013-11-17 |
| 1578908000 | Emily E Tommolino | Internal Medicine | 26850 Providence Pkwy Ste 510, Novi, MI 48374-1267 | 2013-05-10 |
| 1679917074 | Harold Joseph Tobes | Internal Medicine | 1205 Nakomis Trl, Lake Orion, MI 48362-1340 | 2013-04-29 |
| 1245598606 | Ziad Kanaan | Internal Medicine | 215 E Mansion St Ste 3a, Marshall, MI 49068 | 2012-04-24 |
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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.