DR. JOHN COLOMBO (NPI# 1629106851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629106851 |
| Entity Type | Individual |
| Full Name | DR. JOHN COLOMBO |
| Credential | M.D. |
| Practice Address |
22835 Kelly Rd Eastpointe MI 48021-2073 |
| Practice Telephone | 5867784400 |
| Practice Fax Number | 5867783642 |
| Mailing Telephone | 5867784400 |
| Mailing Fax Number | 5867783642 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | JC026758 | MI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TAX ID# | 382385029 | 01 |
| MI | BLUE CROSS BLUE SHIELD | OEO7713 | 01 |
| MI | 3456128 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871654913 | John M Colombo Jr. | Internal Medicine | 501 N Lansdowne Ave, Drexel Hill, PA 19026-1114 | 2006-12-13 |
| 1720158579 | John Domenico Colombo | Family Medicine | 3350 Gratiot Blvd, Marysville, MI 48040-2121 | 2006-11-09 |
| 1003834342 | John Colombo | Specialist | 205 E Palmer Rd, Bellefontaine, OH 43311-2281 | 2006-07-17 |
| 1083671309 | John L Colombo | Pediatrics | 988102 Nebraska Medical Ctr, Omaha, NE 68198-8102 | 2006-04-28 |
| 1780656538 | John Scott Colombo | Physical Therapist | 5635 Steubenville Pike, Mc Kees Rocks, PA 15136-1415 | 2006-02-06 |
| Street Address |
22835 KELLY RD |
| City | EASTPOINTE |
| State | MI |
| Zip Code | 48021-2073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124181763 | East Detroit Ophthalmology P.C. | Specialist | 22835 Kelly Rd, Eastpointe, MI 48021-2073 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588137483 | Beautiful Tomorrow Inc | Home Health | 22430 Gratiot Ave., Eastpointe, MI 48021 | 2019-01-03 |
| 1760922553 | Urgent Care Plus, PC | Clinic/Center | 16184 E 10 Mile Rd Ste 102, Eastpointe, MI 48021 | 2017-02-28 |
| 1295187961 | Danielle Wansley | Licensed Practical Nurse | 24934 Rawen Ave, Eastpointe, MI 48021 | 2016-07-06 |
| 1548615966 | Unique Burton | Licensed Practical Nurse | 15025 Charles, Eastpointe, MI 48021 | 2016-05-04 |
| 1376908707 | Dalinda Richardson | Physical Therapist | 18200 E Tenmile Road, 200, Eastpointe, MI 48021 | 2015-12-30 |
| 1780050369 | Russell Marcilis II | Prosthetic/Orthotic Supplier | 18121 E. 8 Mile Ste 100, Eastpointe, MI 48021 | 2015-08-18 |
| 1841603594 | Charlotte Loraine Kroll | Dentist | 24541 Gratiot Ave., Eastpointe, MI 48021 | 2014-06-10 |
| 1114357720 | Zuri Tanay Boyd-mcgarrity | Social Worker | 4160 Woodward, 2nd Floor, Detroit, MI 48021 | 2013-11-18 |
| 1619219888 | Bettye Ruth Edwards | Social Worker | 23721 Kelly # 7, Eas Pointe, MI 48021 | 2013-03-26 |
| 1578807392 | Angela Marie Travis | Specialist | 21062 Kelly Road, Eastpoint, MI 48021 | 2012-11-16 |
| Find all providers in zip 48021 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316265150 | Michigan Diagnostic Group Plc | Specialist | 17000 E 10 Mile Rd, Eastpointe, MI 48021 | 2010-05-04 |
| 1124181763 | East Detroit Ophthalmology P.C. | Specialist | 22835 Kelly Rd, Eastpointe, MI 48021-2073 | 2006-12-18 |
| 1144677915 | Sheritta Marie Buford | Specialist | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2016-05-20 |
| 1205093275 | Primary Care Physicians II, P.C. | Specialist | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2008-05-19 |
| 1275710725 | A One Michigan Rehab P.C. | Specialist | 18161 E 8 Mile Rd, Eastpointe, MI 48021-3219 | 2008-01-28 |
| 1669686069 | Gary G Bill Md PC | Specialist | 21421 Kelly Rd, Eastpointe, MI 48021-3215 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574118 | Gada Santos | Specialist | 10786 Pine St, Taylor, MI 48180-3440 | 2020-10-07 |
| 1750995361 | Advanced Spinal Reconstruction Pllc | Specialist | 972 Chesterfield Ave, Birmingham, MI 48009-1223 | 2020-09-01 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1235765827 | Magic Touch Salon | Specialist | 746 Burton St Se, Grand Rapids, MI 49507-3204 | 2020-03-16 |
| 1144865411 | Yasmeen Global Beauty Group | Specialist | 21701 W 11 Mile Rd Ste 7, Southfield, MI 48076-3713 | 2019-11-11 |
| 1255990552 | Kboose | Specialist | 3008 Juneberry Ave Se, Grand Rapids, MI 49508-1523 | 2019-06-10 |
| 1124685789 | Grooming Arts Lounge and Gallery | Specialist | 19520 Dorset St, Southfield, MI 48075-7112 | 2019-05-20 |
| 1144787326 | At Home Physician Management Group Co. | Specialist | 27440 Hoover Rd Ste C, Warren, MI 48093-7726 | 2019-02-25 |
| 1821561200 | Bailee J Moffitt | Specialist | 913 W Holmes Rd Unit 200, Lansing, MI 48910-0426 | 2019-01-08 |
| 1871064808 | Shanna E Cook | Specialist | 20843 Garden Ln, Ferndale, MI 48220-2217 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
| City | EASTPOINTE |
| Zip Code | 48021 |
Please comment or provide details below to improve the information on DR. JOHN COLOMBO.
| 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.