MILLENNIUM MEDICAL GROUP SOUTH PC (NPI# 1558500744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558500744 |
| Entity Type | Organization |
| Organization Name | MILLENNIUM MEDICAL GROUP SOUTH PC |
| Other Organization Name | MILLENNIUM SOUTH DIAGNOSTIC CENTER |
| Practice Address |
8850 Telegraph Rd Taylor MI 48180-2316 |
| Practice Telephone | 3132992360 |
| Practice Fax Number | 3132992362 |
| Mailing Telephone | 3132992360 |
| Mailing Fax Number | 3132992362 |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |
| Authorized Official Name | DR. ABRAHAM SLAIM (PRESIDENT) |
| Authorized Official Telephone | 3132953388 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MILLENNIUM SOUTH DIAGNOSTIC CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174762686 | Millennium Medical Group South PC | Clinic/Center | 10501 Telegraph Rd, Taylor, MI 48180-3375 | 2009-02-08 |
| 1265468623 | Millennium Medical Group South PC | Nurse Practitioner | 9340 Telegraph Rd, Taylor, MI 48180-3362 | 2006-06-25 |
| Street Address |
8850 TELEGRAPH RD |
| City | TAYLOR |
| State | MI |
| Zip Code | 48180-2316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063912707 | Ryan Matthew Robertson | Physical Therapist | 8850 Telegraph Rd, Taylor, MI 48180-2316 | 2018-02-20 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891283081 | Nadeem Kandalaft | Radiology | 10000 Telegraph Rd, Taylor, MI 48180 | 2018-04-24 |
| 1205365673 | Melissa Ashley Beck | Radiology | 10000 Telegraph Rd, Taylor, MI 48180-3330 | 2017-06-08 |
| 1225567779 | Yasha Parikh | Radiology | 10000 Telegraph Rd, Taylor, MI 48180-3330 | 2017-06-08 |
| 1306850854 | Oakwood Healthcare, Inc. | Radiology | 10000 Telegraph Rd, Taylor, MI 48180-3330 | 2006-07-28 |
| 1245216977 | Sterling S Kaye | Radiology | 305 Mallard Ln, Taylor, TX 76574-1208 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
| 1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
| 1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
| 1790246627 | Genesis Healthcare | Radiology | 8560 N Silvery Ln Ste 101, Dearborn Heights, MI 48127-4516 | 2019-03-25 |
| 1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
| 1295204253 | Easy Imaging, LLC | Radiology | 16100 19 Mile Rd Ste X, Clinton Township, MI 48038-1148 | 2018-11-20 |
| 1205304888 | Ascension Medical Group Genesys | Radiology | 1096 S Belsay Rd Ste J, Burton, MI 48509-1948 | 2018-11-13 |
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1376072488 | Cambridge Institute of Minimally Invasive Therapies Pllc | Radiology | 2007 E 14 Mile Rd, Sterling Heights, MI 48310-5905 | 2017-06-12 |
| 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.