DETROIT MEDICAL CENTER (NPI# 1679732085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679732085 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Practice Address |
4201 St Antoine Detroit MI 48201 |
| Mailing Address |
4201st Antoine Detroit MI 48201 |
| Practice Telephone | 3137453862 |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |
| Authorized Official Name | WILHELMINE WIESE (M.D) |
| Authorized Official Telephone | 3137453862 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | L1127555 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1619332574 | Detroit Medical Center | Clinic/Center | 43205 Creekview Dr, Canton, MI 48187-3049 | 2015-12-19 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1326279803 | Detroit Medical Center | Special Hospital | 39180 Citation Pl, Apt # 35104, Farmington Hills, MI 48331-4901 | 2009-08-02 |
| 1356510085 | Detroit Medical Center | Clinic/Center | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2008-02-27 |
| 1699327429 | Detroit Medical Center | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2019-07-11 |
| 1205178761 | Detroit Medical Center | Psychiatry & Neurology | 3901 Beaubien St, Department of Neurology, Children's Hospital of Michiga, Detroit, MI 48201-2119 | 2013-03-22 |
| 1346508157 | Detroit Medical Center | Special Hospital | 4160 John R St, Detroit, MI 48201-2020 | 2012-04-30 |
| 1770853251 | Detroit Medical Center | Emergency Medicine | 6071 W Outer Dr, Emergency Medicine Department, Detroit, MI 48235-2624 | 2011-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DETROIT MEDICAL CENTER | 3990 John R St, Detroit, MI 48201-2018 |
| Street Address |
4201 ST ANTOINE |
| City | DETROIT |
| State | MI |
| Zip Code | 48201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689611675 | Mary Beth Lepczyk | Nurse Practitioner | 4201 St Antoine, Ste 5b, Detroit, MI 48201-2153 | 2006-05-31 |
| 1700499654 | Aisha Omer Naeem Elahmadi | Internal Medicine | 4201 St Antoine, Room 2e-uhc, Detroit, MI 48201 | 2020-08-28 |
| 1427679935 | Ivan Alexander Escudero | Student in an Organized Health Care Education/Training Program | 4201 St Antoine, Uhc-9c, Detroit, MI 48201 | 2020-05-06 |
| 1821619552 | Tushar Anil Shetty | Student in an Organized Health Care Education/Training Program | 4201 St Antoine, Uhc4c, Detroit, MI 48201 | 2020-05-05 |
| 1922628676 | Nathan Patrick Tausch | Student in an Organized Health Care Education/Training Program | 4201 St Antoine, Rm 6g-uhc, Detroit, MI 48201 | 2020-04-23 |
| 1720641798 | Andrew Harb | Student in an Organized Health Care Education/Training Program | 4201 St Antoine, Uhc, Detroit, MI 48201 | 2019-04-16 |
| 1508394941 | Aslan Efendizade | Student in an Organized Health Care Education/Training Program | 4201 St Antoine, Umc 9c, Detroit, MI 48027 | 2017-05-30 |
| 1821351396 | Regina Dupe Nagy | Obstetrics & Gynecology | 4201 St Antoine, Ste 4c, Detroit, MI 48201-2153 | 2012-06-20 |
| 1154559664 | Krishna Balabhadrapatruni | Internal Medicine | 4201 St Antoine, Uhc 5c, Detroit, MI 48201 | 2009-06-24 |
| 1518116623 | Darlene Joyce Allen | Midwife | 4201 St Antoine, Ste 4c, Detroit, MI 48201-2153 | 2008-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| 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 |
|---|---|---|---|---|
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1871053751 | Jacob Diskin | Internal Medicine | 4201 St. Antione, Uhc 9c, Detroit, MI 48201 | 2019-03-25 |
| 1770092272 | Daniel Saul Mizrahi | Internal Medicine | 7633 E Jefferson Ave Ste 250, Detroit, MI 48214-3731 | 2017-09-27 |
| 1700304912 | Premier Care Rehabilitation | Internal Medicine | 10641 W Mcnichols Rd, Detroit, MI 48221-2303 | 2017-09-07 |
| 1427400431 | Aryan Shiari | Internal Medicine | 3990 John R St Rm Room3925, Detroit, MI 48201-2018 | 2016-07-01 |
| 1700236478 | Osh-mi Physicians Group PC | Internal Medicine | 18600 Fenkell St, Detroit, MI 48223-2315 | 2016-06-14 |
| 1184070815 | Khalil Ibrahim Bourji | Internal Medicine | 4201 Saint Antoine St Ste 4h, Detroit, MI 48201 | 2016-05-12 |
| 1124403779 | Swetha Edla | Internal Medicine | 22101 Moross Road Pb Suite 50, Detroit, MI 48236 | 2015-07-24 |
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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.