DR. MICHAEL JOHN SUPERIOR (NPI# 1629164447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629164447 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JOHN SUPERIOR |
| Credential | MD, MPH |
| Practice Address |
5158 Black Hawk Rd Aberdeen Proving Ground MD 21010-5403 |
| Practice Telephone | 4104365127 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2017-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
62171 | GA | Allopathic & Osteopathic Physicians |
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
C1-0008620 | DE | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
25MA09423100 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
5158 BLACK HAWK RD |
| City | ABERDEEN PROVING GROUND |
| State | MD |
| Zip Code | 21010-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467978932 | Kim Theresa Pierre | Audiologist | 5158 Black Hawk Rd, Aberdeen Proving Ground, MD 21010-5403 | 2017-08-16 |
| 1891765111 | Steven Brian Cersovsky | Preventive Medicine | 5158 Black Hawk Rd, Aberdeen Proving Ground, MD 21010-5403 | 2006-01-26 |
| 1699766956 | Valerie K. Sommer | Registered Nurse | 5158 Black Hawk Rd, Ctr for Health Promotion & Preventive Medicine, Aberdeen Proving Ground, MD 21010-5403 | 2005-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144481128 | Joseph S. Jones | Preventive Medicine | Army Public Health Command, 5158 Black Hawk Rd, Gunpowder, MD 21010 | 2008-06-23 |
| 1104980150 | Bonnie J Parham | Licensed Practical Nurse | 4110 Austin Road, Gunpowder, MD 21010 | 2006-12-21 |
| 1649214735 | John Hill Barker Jr. | Dentist | Bldg. E4110, Austin Road, Edgewood Dental Clinic, Apg Edgewood Area, MD 21010 | 2006-06-16 |
| 1093910374 | Kimbrough Acc Military Mtf | Clinic/Center | 4110 Austin Road, Aberdeen Proving Ground, MD 21010 | 2007-06-18 |
| 1770686636 | James Malcolm Madsen | Pathology | 3100 Ricketts Point Rd, Usamricd, Attn: Mcmr-cdm (col Madsen), Gunpowder, MD 21010-5400 | 2006-09-06 |
| 1063572501 | Charles Gary Hurst | Dermatology | 3100 Ricketts Point Rd, Gunpowder, MD 21010-5400 | 2006-12-12 |
| 1013064666 | Sally Siefert Hoedebecke | Dietitian, Registered | 5158 Black Hawk Rd Bldg E1930, Aberdeen Proving Ground, MD 21010-5403 | 2007-01-05 |
| 1578543062 | Michael Duane Pattison | Optometrist | Tsvcrd, Aphc, Attn: Mchb-ph-vcr, 8252 Blackhawk Road, Aberdeen Proving Ground, MD 21010-5403 | 2006-01-19 |
| 1619025632 | Vivian Carol Rush | Preventive Medicine | Usachppm, Mchb-ts-mem(rush), Apg, MD 21010-5422 | 2007-01-08 |
| 1225097256 | James Patrick Gerkin Sr. | Registered Nurse | 5183 Black Hawk Rd, Aberdeen Proving Ground, MD 21010-5424 | 2006-03-20 |
| Find all providers in zip 21010 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| 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 Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568430759 | Kevin P. Michaels | Preventive Medicine | Kirk U.S. Army Health Clinic, 2501 Oakington St, Aberdeen Proving Ground, MD 21005 | 2006-03-14 |
| 1477623163 | Charles E Mccannon | Preventive Medicine | 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 | 2006-11-09 |
| 1891765111 | Steven Brian Cersovsky | Preventive Medicine | 5158 Black Hawk Rd, Aberdeen Proving Ground, MD 21010-5403 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306486360 | World At Ease | Preventive Medicine | 8400 Cedar St, Silver Spring, MD 20910-5537 | 2020-01-08 |
| 1861051179 | Anil Rajpal | Preventive Medicine | 10903 New Hampshire Ave Rm 5132, Silver Spring, MD 20993-0002 | 2019-06-10 |
| 1205490505 | M. Miles Braun | Preventive Medicine | 13325 Bondy Way, Gaithersburg, MD 20878-2124 | 2019-04-23 |
| 1326585928 | Jesse Polansky | Preventive Medicine | 701 Gilmarys Rd, Baltimore, MD 21210-1416 | 2017-01-21 |
| 1225437775 | Patrick Kelley | Preventive Medicine | 1935 Kimberly Rd, Silver Spring, MD 20903-1221 | 2014-08-21 |
| 1346649027 | Maria Agelli | Preventive Medicine | 4853 Cordell Ave Apt 907, Bethesda, MD 20814-3024 | 2014-08-19 |
| 1326475864 | Gillian Ann Vanblerk | Preventive Medicine | 1657 Eton Way, Crofton, MD 21114-1512 | 2013-09-30 |
| 1790028231 | Karl C Klontz | Preventive Medicine | 5100 Paint Branch Pkwy, Hfs-005, College Park, MD 20740-3835 | 2013-04-03 |
| 1225370117 | Leslie G Ford | Preventive Medicine | 5533 Mohican Rd, Bethesda, MD 20816-2159 | 2013-03-19 |
| 1003154956 | David D Nicholas | Preventive Medicine | 7200 Wisconsin Ave, Suite 600, Bethesda, MD 20814-4811 | 2013-01-28 |
| Find all providers with the same taxonomy | ||||
| City | ABERDEEN PROVING GROUND |
| Zip Code | 21010 |
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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.