EAST DETROIT PAIN AND REHAB PLLC (NPI# 1699168146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699168146 |
| Entity Type | Organization |
| Organization Name | EAST DETROIT PAIN AND REHAB PLLC |
| Practice Address |
10575 Morang Dr Detroit MI 48224-1880 |
| Practice Telephone | 3138845477 |
| Practice Fax Number | 3138845478 |
| Mailing Telephone | 3138845477 |
| Mailing Fax Number | 3138845478 |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | DR. JEFFREY LEE MATFUS (OWNER) |
| Authorized Official Telephone | 2012941010 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207R00000X | Internal Medicine | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00409105 | 05 |
| Street Address |
10575 MORANG DR |
| City | DETROIT |
| State | MI |
| Zip Code | 48224-1880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942494117 | Raymond J Kaminski | Chiropractor | 10575 Morang Dr, Detroit, MI 48224-1880 | 2007-08-30 |
| 1407033707 | Kaminski Chiropractic Life Center | Chiropractor | 10575 Morang Dr, Detroit, MI 48224-1880 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508403767 | Renia Scott | Licensed Practical Nurse | 5211 Berkshire St, Detroit, MI 48224 | 2019-12-06 |
| 1063928612 | Edith Neely-harris | Registered Nurse | 1203 Courville Street, Detroit, MI 48224 | 2017-12-19 |
| 1043767585 | Annette Jackson | Counselor | 10666 Duprey St, Detroit, MI 48224 | 2016-09-01 |
| 1164977807 | Dehvin White-peck | Technician, Other | 4529 Harvard Rd, Detroit, MI 48224 | 2016-08-23 |
| 1992153704 | Andrea Henderson | Licensed Practical Nurse | 9131 Bradford, Detroit, MI 48224 | 2016-06-02 |
| 1467807578 | Venus Staffing LLC | Nursing Care | 5601 Devonshire Rd, Detroit, MI 48224 | 2016-04-26 |
| 1558795625 | Rafia El-alayli | Internal Medicine | 9901 Whittier Ave, Detroit, MI 48224 | 2013-08-26 |
| 1831334259 | House of Hearts Ministry, Inc. | Voluntary or Charitable | 11151 Worden, Detroit, MI 48224 | 2008-12-15 |
| 1992994636 | Lilian Lai Md PC | Clinic/Center | 15850 E Warren Ave, Detroit, MI 48224 | 2007-10-18 |
| 1184845844 | Tymon C Totte | Dentist | 17700 Mack Ave, Great Expressions Dental Centers, Gross Pointe, MI 48224 | 2007-05-01 |
| Find all providers in zip 48224 | ||||
| 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 |
| Find all providers in DETROIT | ||||
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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.