DR. BORIS TKACH (NPI# 1518496942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518496942 |
| Entity Type | Individual |
| Full Name | DR. BORIS TKACH |
| Credential | DO |
| Practice Address |
50 N. Perry Pontiac MI 48342 |
| Mailing Address |
50 N Perry St Pontiac MI 48342-2217 |
| Practice Telephone | (760) 622-5516 |
| Mailing Telephone | 7606225516 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
50 N. PERRY |
| City | PONTIAC |
| State | MI |
| Zip Code | 48342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528589561 | Beloved Home Care LLC. | Home Health | 12 S Mill. St., Apt.314, Pontiac, MI 48342 | 2017-06-29 |
| 1023547429 | Nicholas James Stepanski | Student in an Organized Health Care Education/Training Program | 50 N. Perry St., Pontiac, MI 48342 | 2017-06-08 |
| 1245769991 | Mecca House Corporation | Assisted Living Facility | 53 West Huron, Pontiac, MI 48342 | 2017-06-07 |
| 1134672868 | Shannon Blaine | Technician, Other | 103 Parkhurst Street, Pontiac, MI 48342 | 2016-07-29 |
| 1669819249 | Bonnie Ann Smith | Occupational Therapist | 60 Parkhurst Dr., Pontiac, MI 48342 | 2013-05-23 |
| 1205123361 | Mary Ellen Kenworthy | Emergency Medicine | 50 North Perry Street, Pontiac, MI 48342 | 2011-07-08 |
| 1740516343 | Nathima Habib Atchoo | Obstetrics & Gynecology | 90 West University, Gary Burnstein Community Health Clinic (free Clinic), Pontiac, MI 48342 | 2009-11-02 |
| 1881824233 | Sylvia Lyn Thompson | Physical Therapist | 900 Auburn Road, Pontiac, MI 48342 | 2009-07-20 |
| 1114154150 | Kyannah Toyann Anderson | Home Health | 175 S.edith St, Pontiac, MI 48342 | 2009-06-17 |
| 1508027475 | Community Programs Inc | Skilled Nursing Facility | 540 Boyd St, Pontiac, MI 48342 | 2008-06-23 |
| Find all providers in zip 48342 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1245850064 | Alexandra Lenox | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave Dept H-90, Pontiac, MI 48341-5023 | 2020-04-22 |
| 1568081800 | Jean-yves Reshad Nazroo | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave, Medical Education H-23, Pontiac, MI 48341-2985 | 2020-04-15 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| 1831682269 | Swathi Muthyam Mogulla | Student in an Organized Health Care Education/Training Program | St Joseph Mercy Oakland, 44405 Woodward Avenue, Pontiac, MI 48361 | 2018-06-11 |
| 1023547429 | Nicholas James Stepanski | Student in an Organized Health Care Education/Training Program | 50 N. Perry St., Pontiac, MI 48342 | 2017-06-08 |
| Find all providers in PONTIAC | ||||
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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.