DR. CLARENCE BENJAMIN VAUGHN (NPI# 1538105309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538105309 |
| Entity Type | Individual |
| Full Name | DR. CLARENCE BENJAMIN VAUGHN |
| Credential | M.D., PH.D. |
| Practice Address |
22255 Greenfield Rd Suite 450 Southfield MI 48075-3710 |
| Practice Telephone | 2483562828 |
| Practice Fax Number | 2483568805 |
| Mailing Telephone | 2483562828 |
| Mailing Fax Number | 2483568805 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2014-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
43010225814 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | P51884 | 01 |
| MI | BCBS | CV025814 | 01 |
| MI | BLUE SHIELD ID # | OF36464 | 01 |
| MI | 2570861 TYPE:10 | 05 | |
| MI | STATE LICENSE | 4301025814 | 01 |
| MI | DEA | AV3111200 | 01 |
| Street Address |
22255 GREENFIELD RD SUITE 450 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-3710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235136599 | William B Blessed | Obstetrics & Gynecology | 22255 Greenfield Rd, Ste 350, Southfield, MI 48075-3712 | 2005-07-01 |
| 1760006977 | Jessica Eastwood | Obstetrics & Gynecology | 22255 Greenfield Rd, Suite #352, Southfield, MI 48075 | 2020-06-03 |
| 1740826965 | Kella Hayward | Student in an Organized Health Care Education/Training Program | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2019-11-22 |
| 1659937647 | Brittley Morgan Leppien | Student in an Organized Health Care Education/Training Program | 22255 Greenfield Rd, Suite 352, Southfield, MI 48075-3710 | 2019-05-15 |
| 1821651951 | Ene Grace Morgan | Student in an Organized Health Care Education/Training Program | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2019-04-15 |
| 1386114213 | Christopher Ryan | Physical Medicine & Rehabilitation | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2018-12-04 |
| 1427550342 | Victoria Ann Kozemchak | Physical Therapist | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2018-03-07 |
| 1740789197 | Katie Weingartz | Physical Therapist | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2018-02-12 |
| 1144729054 | Shelley Adams | Physical Therapist | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2018-02-06 |
| 1316462435 | Samantha Beth Rosenbloom | Social Worker | 22255 Greenfield Rd, Southfield, MI 48075-3710 | 2017-08-09 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972996544 | Britni Souther | Internal Medicine | 28411 Northwestern Hwy Ste 1050, Southfield, MI 48034 | 2015-03-06 |
| 1275892176 | L. Dizon, M.d. P.C. | Internal Medicine | 20307 W 12 Mile Rd, Suite 102, Southfield, MI 48076-5407 | 2012-05-11 |
| 1558544510 | Andrew Aaron Muskovitz | Internal Medicine | 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075-3707 | 2007-12-13 |
| 1982816179 | Rim Naim Turfa | Internal Medicine | 16001 West Nine Mile Rd, Southfield, MI 48075 | 2007-05-03 |
| 1760413389 | Robert E. Bloom | Internal Medicine | 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075-3707 | 2006-07-05 |
| 1003852732 | Judie R. Goodman | Internal Medicine | 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075-3707 | 2006-06-21 |
| 1457395444 | Howard R. Terebelo | Internal Medicine | 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075-3707 | 2006-06-16 |
| 1225072275 | Lyle Steven Goldman | Internal Medicine | 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075-3707 | 2006-06-16 |
| 1851341549 | Lourdes Plenos Dizon | Internal Medicine | 20307 W 12 Mile Rd, Southfield, MI 48076-5407 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346887692 | Michigan Center for Hematology and Oncology | Internal Medicine | 28111 Hoover Rd Ste 5a, Warren, MI 48093-4153 | 2019-12-05 |
| 1487093274 | Heidi M Egloff | Internal Medicine | 1140 E Michigan Ave, Lansing, MI 48912-1805 | 2013-06-14 |
| 1588008809 | Roba Alhasan | Internal Medicine | 4900 Mercury Dr Ste 100, Dearborn, MI 48126-2947 | 2013-04-18 |
| 1285975151 | David Allen Leichtman | Internal Medicine | 5216 Mirror Lake Ct, West Bloomfield, MI 48323-1536 | 2013-03-02 |
| 1184988750 | Musnon Medical Center | Internal Medicine | 4960 Skyview Court, Traverse City, MI 49684-7173 | 2012-06-28 |
| 1659634772 | Leann Michelle Blankenship | Internal Medicine | 3577 W 13 Mile Rd Ste 202, Royal Oak, MI 48073-6710 | 2012-06-22 |
| 1609160928 | Iha Health Services Corporation | Internal Medicine | 5301 E Huron River Dr Ste 210, Ypsilanti, MI 48197-1051 | 2011-06-03 |
| 1366733156 | Nakul Singhal | Internal Medicine | 5015 Oak Tree Ct, Ann Arbor, MI 48108-8573 | 2011-04-27 |
| 1275859704 | Elon Knoll | Internal Medicine | 11885 E 12 Mile Rd Ste 100a, Warren, MI 48093-3465 | 2010-04-08 |
| 1598911448 | Mohammad Muhsin Chisti | Internal Medicine | 44199 Dequindre Rd Ste G-10, Troy, MI 48085-1128 | 2008-08-12 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on DR. CLARENCE BENJAMIN VAUGHN.
| 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.