THOMAS G COSTANTINO (NPI# 1710926399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710926399 |
| Entity Type | Individual |
| Full Name | THOMAS G COSTANTINO |
| Credential | DO |
| Practice Address |
14319 Dix Toledo Rd Southgate MI 48195-2506 |
| Mailing Address |
26901 Beaumont Blvd Ste 3d Southfield MI 48033-3849 |
| Practice Telephone | 7342850677 |
| Practice Fax Number | 7342853574 |
| Mailing Telephone | 9475221863 |
| Mailing Fax Number | 9475220307 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101006373 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| M-CARE | C3241 | 01 | |
| HEALTH ALLIANCE PLAN | E26804 | 01 | |
| MEDICARE RAILROAD | 791126254 | 01 | |
| MI | 111059129 | 05 | |
| MI | BLUE CROSS | 5823153 | 01 |
| CARE CHOICES | 125036 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316916422 | Thomas Guy Costantino Jr. | Emergency Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2006-03-14 |
| 1881692143 | Thomas Costantino | Internal Medicine | 501 Seaview Ave, Suite 302, Staten Island, NY 10305-3436 | 2005-07-11 |
| Street Address |
14319 DIX TOLEDO RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659356400 | Douglas John Zakolski | Internal Medicine | 14319 Dix Toledo Rd, Southgate, MI 48195-2506 | 2005-12-14 |
| 1780904748 | Vip Pharmacy Inc | Pharmacy | 14319 Dix Toledo Rd, Southgate, MI 48195-2506 | 2010-06-01 |
| 1295808426 | Blanzy Clinic | Family Medicine | 14319 Dix Toledo Rd, Southgate, MI 48195-2506 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023272994 | Manish Bolina | Family Medicine | 15777 Northline Rd Ste 101, Southgate, MI 48195-2300 | 2008-07-10 |
| 1942351820 | Sita Ram Kaura | Family Medicine | 14797 Dix Toledo Rd, Southgate, MI 48195-2507 | 2007-01-16 |
| 1679645972 | Edward Nazareno | Family Medicine | 13650 Fort St, Southgate, MI 48195-1152 | 2006-11-14 |
| 1629017207 | John E Blanzy | Family Medicine | 14319 Dix-toledo Rd, Southgate, MI 48195 | 2006-06-06 |
| 1649243676 | Joel A. Perlson | Family Medicine | 15777 Northline Rd Ste 200, Southgate, MI 48195-2354 | 2006-02-09 |
| 1326021262 | Thomas M Pinson | Family Medicine | 13636 Dix Toledo Rd, Southgate, MI 48195-2432 | 2005-11-23 |
| 1770585580 | Michael Lawrence Gambel | Family Medicine | 12100 Dix Toledo Rd, Southgate, MI 48195-3531 | 2005-08-11 |
| 1376542035 | Farah Iftikhar | Family Medicine | 15777 Northline Rd, Southgate, MI 48195-2385 | 2005-07-15 |
| 1295356772 | Priority 1 Health Pllc | Family Medicine | 15450 Northline Rd, Southgate, MI 48195-2398 | 2020-05-06 |
| 1992156418 | Raathathulaksi Krishnamohan | Family Medicine | 13667 Eureka Rd, Southgate, MI 48195-1332 | 2016-06-27 |
| Find all providers in SOUTHGATE | ||||
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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.