MR. ROBERT PETTAWAY (NPI# 1598316119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598316119 |
Entity Type | Individual |
Full Name | MR. ROBERT PETTAWAY |
Practice Address |
2995 E Grand Blvd Detroit MI 48202-3133 |
Practice Telephone | 3137580150 |
Enumeration Date | 2019-09-25 |
Last Update Date | 2019-09-25 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
5555 Conner St, Detroit, MI 482133448 | 3133080255 |
Street Address |
2995 E GRAND BLVD |
City | DETROIT |
State | MI |
Zip Code | 48202-3133 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821120445 | Black Family Development, Inc. | Community/Behavioral Health | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2007-03-09 |
1710591698 | Danayzha Williams | Social Worker | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2020-09-08 |
1417561390 | Erin Davies | Social Worker | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2020-09-08 |
1790328284 | Juana Michell Scandrick | Social Worker | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2019-10-28 |
1023659489 | Niga Myisha Mccamey | Social Worker | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2019-10-07 |
1346897311 | Darleen N/a Mccoy | Counselor | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2019-08-23 |
1891278172 | Ashley Ballard | Counselor | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2018-09-12 |
1376051300 | Rahnetta Sophia Stephens | Counselor | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2018-01-11 |
1205341856 | Sharon Demetria Mcfolley | Case Manager/Care Coordinator | 2995 E Grand Blvd, Detroit, MI 48202-3133 | 2017-12-05 |
1558718502 | Jacqueline Maria Beavers | Social Worker | 2995 E Grand Blvd, Detroit, MI 48202 | 2016-05-19 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
Find all providers in zip 48202 |
Taxonomy Code | 247200000X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Technician, Other |
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952889743 | Myesha Gibson Wilson | Technician, Other | 22457 Kendall St, Detroit, MI 48223-2542 | 2018-08-02 |
1871071647 | Deidre Flowers | Technician, Other | 6776 Stahelin Ave # 23, Detroit, MI 48228-3465 | 2018-08-02 |
1750828489 | Charneil Tuggle | Technician, Other | 19017 Pierson St, Detroit, MI 48219-2517 | 2017-01-19 |
1720523293 | Eno Esu | Technician, Other | 8136 Appoline St, Detroit, MI 48228-4002 | 2016-12-20 |
1710420195 | Cassandra Wells | Technician, Other | 11691 Beaverland, Detroit, MI 48239-1358 | 2016-12-02 |
1306389945 | Arnesha Bernice Jennings | Technician, Other | 19210 Robson St, Detroit, MI 48235-1949 | 2016-11-30 |
1962945444 | Diane Christiine Issa | Technician, Other | 5081 Garland St, Detroit, MI 48213-3366 | 2016-11-30 |
1164974358 | Xavier Robertson | Technician, Other | 18451 Northlawn St, Detroit, MI 48221-2019 | 2016-11-04 |
1518418631 | Luebertha Mcclellan | Technician, Other | 15346 Dexter Ave, Detroit, MI 48238-2127 | 2016-10-24 |
1558812891 | Tommie D Dotson | Technician, Other | 19360 Renfrew Rd, Detroit, MI 48221-1836 | 2016-10-21 |
Find all providers in DETROIT |
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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.