MEDPRO PRIMARY CARE PLLC (NPI# 1639700107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639700107 |
| Entity Type | Organization |
| Organization Name | MEDPRO PRIMARY CARE PLLC |
| Practice Address |
17901 Huron River Dr New Boston MI 48164-3200 |
| Practice Telephone | 7343157070 |
| Mailing Telephone | 7343157070 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-22 |
| Authorized Official Name | JOSHUA RUEDISUELI (OWNER) |
| Authorized Official Telephone | 7343157070 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
17901 HURON RIVER DR |
| City | NEW BOSTON |
| State | MI |
| Zip Code | 48164-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205827383 | Paul Kent Voreis | Optometrist | 17901 Huron River Dr, Suite 101, New Boston, MI 48164-3200 | 2005-10-29 |
| 1972706513 | Voreis Eye Care, P.C. | Optometrist | 17901 Huron River Dr, Suite 101, New Boston, MI 48164-3200 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033545397 | Kimberly Ann Bailey | Social Worker | 18638 Lawrence Lane, New Boston, MI 48164 | 2013-09-18 |
| 1831378447 | Dario Merlos | Dentist | 37228 Huron River Dr, New Boston, MI 48164 | 2007-10-31 |
| 1275636342 | New Boston Dental Clinic PC | Dentist | 37228 Huron River Dr, New Boston, MI 48164-0217 | 2006-09-06 |
| 1114441706 | Christina Erin Crutchfield | Speech-Language Pathologist | 23504 W Creek Dr, New Boston, MI 48164-7827 | 2017-07-26 |
| 1194172981 | Moya Tara Talley | Nurse Practitioner | 25140 Austin Dr, New Boston, MI 48164-8907 | 2016-05-21 |
| 1194964817 | Kristy Marie Cheslick | Occupational Therapist | 18655 Andrew Ln, New Boston, MI 48164-8915 | 2009-02-19 |
| 1861637266 | Duane Arthur Galloway | Registered Nurse | 26739 Trowbridge Sq, New Boston, MI 48164-8960 | 2008-12-13 |
| 1912556762 | Adam Liparoto | Nurse Practitioner | 27158 John Dr, New Boston, MI 48164-9048 | 2019-09-04 |
| 1447458799 | Jeremy Marra | Specialist/Technologist | 27165 John Dr, New Boston, MI 48164-9049 | 2007-07-09 |
| 1598390379 | Roger Bradford | Home Health Aide | 25965 Frances Ln, New Boston, MI 48164-9176 | 2020-03-11 |
| Find all providers in zip 48164 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023076924 | Louise Cantey Hasell | Internal Medicine | 4038 Rhodes Ave, New Boston, OH 45662-5527 | 2006-05-02 |
| 1417912742 | Toms P Mathew | Internal Medicine | 19270 Hannan Rd, New Boston, MI 48164-9811 | 2006-04-19 |
| 1770798142 | Toms P. Mathew M.d., P.C. | Internal Medicine | 19270 Hannan Rd, New Boston, MI 48164-9811 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| Find all providers with the same taxonomy | ||||
| City | NEW BOSTON |
| Zip Code | 48164 |
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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.