MARTIN KORNBLUM (NPI# 1679562722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679562722 |
Entity Type | Individual |
Full Name | MARTIN KORNBLUM |
Practice Address |
11885 E 12 Mile Rd 200b Warren MI 48093-3474 |
Mailing Address |
43800 Garfield Rd Clinton Twp MI 48038-1136 |
Practice Telephone | 5865827070 |
Practice Fax Number | 5865827066 |
Mailing Telephone | 8008480202 |
Mailing Fax Number | 5862266949 |
Enumeration Date | 2005-10-20 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
4301063387 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 4209319 | 05 |
Street Address |
11885 E 12 MILE RD 200B |
City | WARREN |
State | MI |
Zip Code | 48093-3474 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093711459 | Comprehensive Counseling Center PC | Clinic/Center | 11885 E 12 Mile Rd, Ste. 201a, Warren, MI 48093-3474 | 2005-06-21 |
1801417373 | Shayla Patton | Student in an Organized Health Care Education/Training Program | 11885 E 12 Mile Rd, Warren, MI 48093-3474 | 2020-05-06 |
1184244352 | Jessica Frazelle Mcdaniel | Student in an Organized Health Care Education/Training Program | 11885 E 12 Mile Rd, Warren, MI 48093-3474 | 2020-04-17 |
1710540950 | Jessica Marie Fisher | Nurse Practitioner | 11885 E 12 Mile Rd, Warren, MI 48093-3474 | 2019-04-14 |
1285094706 | Kathleen Anne Quinn | Obstetrics & Gynecology | 11885 E 12 Mile Rd, Suite 202a, Warren, MI 48093-3474 | 2016-02-25 |
1770822306 | Sudhir Lingnurkar Md Plc | Psychiatry & Neurology | 11885 E 12 Mile Rd, Ste 204a, Warren, MI 48093-3474 | 2013-02-01 |
1871856310 | Joshua Aaron Rosenbloom | Internal Medicine | 11885 E 12 Mile Rd, Ste. 300a, Warren, MI 48093-3474 | 2012-06-20 |
1710249826 | Shirley Orock Ayuk-takem | Internal Medicine | 11885 E 12 Mile Rd, Ste. 300a, Warren, MI 48093-3474 | 2012-06-14 |
1053672048 | Hamid Abbas Afsari | Internal Medicine | 11885 E 12 Mile Rd, Ste. 300a, Warren, MI 48093-3474 | 2012-06-06 |
1497015002 | Jake Graehm Halvorsen | Internal Medicine | 11885 E 12 Mile Rd, Ste. 300a, Warren, MI 48093-3474 | 2012-05-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
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Taxonomy Code | 207XS0117X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Orthopaedic Surgery of the Spine |
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861597247 | Stanley E. Grzyb | Orthopaedic Surgery | 1840 Sugarbush Access Road, Warren, VT 05674-9747 | 2006-09-13 |
1033143052 | Jeffrey K. Wingate, M.d. | Orthopaedic Surgery | 13355 East Ten Mile Road, Medical Office Building East Ste. 115, Warren, MI 48089 | 2006-07-10 |
1013944586 | Kevin A Mccracken | Orthopaedic Surgery | 45 Mountain Blvd, Bldg D Suite 2, Warren, NJ 07059-5678 | 2006-06-28 |
1235699646 | New Vision Rehab Center Inc | Orthopaedic Surgery | 13087 E 11 Mile Rd, Warren, MI 48088-4795 | 2019-03-21 |
1447529839 | Orthopaedic & Spine Center of New Jersey | Orthopaedic Surgery | 45 Mountain Blvd, Bldg D, Suite 2, Warren, NJ 07059-2635 | 2011-12-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144650391 | Accuspine Pllc | Orthopaedic Surgery | 612 Park St, Birmingham, MI 48009-3424 | 2013-11-24 |
1669809612 | Michigan Orthopaedic Spine Surgeons PC | Orthopaedic Surgery | 29624 Woodward Ave, Royal Oak, MI 48073-0905 | 2013-10-07 |
1376808105 | Lucent Spine, Pllc | Orthopaedic Surgery | 2300 Haggerty Rd Ste 2100, West Bloomfield, MI 48323-2191 | 2012-07-09 |
1689605925 | Philip Jeffery Mayer | Orthopaedic Surgery | 9389 N Haggerty Rd, Plymouth, MI 48170-4622 | 2006-07-05 |
1235117524 | Jeffrey K Wingate | Orthopaedic Surgery | 555 Barclay Cir Ste 140, Rochester Hills, MI 48307-4587 | 2006-01-06 |
1801870266 | Edgar Neil Pasia | Orthopaedic Surgery | 940 River Centre Dr., Port Huron, MI 48060 | 2005-11-30 |
1194713669 | Kenneth J Easton | Orthopaedic Surgery | 1111 Leffingwell Ne, Ste 100, Grand Rapids, MI 49525 | 2005-10-10 |
1669465761 | John Ernest Lamacchia | Orthopaedic Surgery | 1135 W University Dr Ste 450, Rochester, MI 48307-1871 | 2005-08-24 |
1104458181 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-02-07 |
1124589460 | Smi Care of Mi, LLC | Orthopaedic Surgery | 755 W Big Beaver Rd Ste 2020, Troy, MI 48084-4925 | 2019-03-28 |
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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.