DR. JOHANN ELI GUDJONSSON (NPI# 1710004866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710004866 |
| Entity Type | Individual |
| Full Name | DR. JOHANN ELI GUDJONSSON |
| Credential | MD |
| Practice Address |
1500 E Medical Center Dr 1st Floor Taubman Ctr Recp B Ann Arbor MI 48109-5314 |
| Mailing Address |
3621 S State St 700 Kms Place Ann Arbor MI 48108 |
| Practice Telephone | 7349364054 |
| Mailing Telephone | 7349362047 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4301082622 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301082622 | MI | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CONTROLLED SUBSTANCE LICE | 5315015456 | 01 |
| Street Address |
1500 E MEDICAL CENTER DR 1ST FLOOR TAUBMAN CTR RECP B |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-5314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475836 | Tami L. Remington | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-0999 | 2005-05-23 |
| 1578164810 | Jessica Leigh Bailey | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-11-03 |
| 1518565910 | Yoshiaki Ota | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-10-16 |
| 1366058356 | Paulo Zupelari Goncalves | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-09-16 |
| 1306459466 | Jesse P Spalding | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1992318919 | Batoul Berri | Audiologist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1063024891 | Nathan Allen Johnson | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-22 |
| 1780296699 | Yoav Hammer | Internal Medicine | 1500 E Medical Center Dr, 2nd Floor, Cardiovascular Center, Ann Arbor, MI 48109-5853 | 2020-08-21 |
| 1891306262 | Sarah Garnai | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-11 |
| 1386254936 | Ryan James Sutherlan | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1174915532 | Sonam Rama | Dermatology | 305 E Eisenhower Pkwy Ste 320, Ann Arbor, MI 48108 | 2015-02-23 |
| 1235576174 | Matthew Paul Vasievich | Dermatology | 4200 Whitehall Dr Ste 250, Ann Arbor, MI 48105-9694 | 2013-06-02 |
| 1013114602 | Frank Wang | Dermatology | 1500 E. Medical Ctr Dr, 1st Floor Taubman Center Recp B, Ann Arbor, MI 48109-5314 | 2007-06-28 |
| 1306967542 | Arthur P Bertolino | Dermatology | 2800 Plymouth Rd, Ann Arbor, MI 48105-2430 | 2007-04-03 |
| 1770673436 | Anastasia Petro Dimick | Dermatology | 2433 Oak Valley Dr., Ste. 400, Ann Arbor, MI 48103 | 2006-10-13 |
| 1962592626 | Kathy Laing, M.d., P.C. | Dermatology | 2433 Oak Valley Drive, Suite 400, Ann Arbor, MI 48103 | 2006-10-13 |
| 1255428025 | Timothy M Johnson | Dermatology | 1979 Huron Pkwy, Ann Arbor, MI 48104-4141 | 2006-10-05 |
| 1487600474 | Muna K. Farjo,m.d., P.C. | Dermatology | 3001 Plymouth Rd, Suite # 101, Ann Arbor, MI 48105-3205 | 2006-05-25 |
| 1407841349 | Joan Marie Rindler | Dermatology | 2301 S Huron Pkwy, Suite 2b, Ann Arbor, MI 48104-5133 | 2005-09-16 |
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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.