LAKESIDE URGENT CARE, P. C. (NPI# 1720159304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720159304 |
| Entity Type | Organization |
| Organization Name | LAKESIDE URGENT CARE, P. C. |
| Practice Address |
44472 Hayes Rd Clinton Township MI 48038-1090 |
| Practice Telephone | 5864120890 |
| Practice Fax Number | 5864121065 |
| Mailing Telephone | 5864120890 |
| Mailing Fax Number | 5864121065 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2009-07-21 |
| Authorized Official Name | MRS. TABATHA LEANNE STAGE (BILLING MANAGER) |
| Authorized Official Telephone | 2488532009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 207R00000X | Internal Medicine | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1720159304 | 05 | |
| BLUE CARE NETWORK OF MICHIGAN | 700E001600 | 01 | |
| MI | BCBS OF MICHIGAN | 700E001600 | 01 |
| MI | HAP | ON82490 | 01 |
| MI | BCBS OF MICHIGAN | 1106354161 | 01 |
| MI | COMMERCIAL | 1720159304 | 01 |
| Street Address |
44472 HAYES RD |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48038-1090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568947208 | Colleen Gabriel | Nurse Practitioner | 44472 Hayes Rd, Clinton Township, MI 48038-1090 | 2018-09-28 |
| 1811226442 | Lakeside Urgent Care, P.C. | Internal Medicine | 44472 Hayes Rd, Clinton Township, MI 48038-1090 | 2009-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| 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 |
|---|---|---|---|---|
| 1508132283 | Jonathan Edward Beaulac | Internal Medicine | 15855 Nineteen Mile Rd., Henry Ford Macomb Hospital, Clinton Township, MI 48038 | 2012-03-28 |
| 1457664864 | Aalok Dave | Internal Medicine | 15885 19 Mile, Henry Ford Macomb Hospital, Clinton Township, MI 48038 | 2010-07-15 |
| 1255512661 | Vasudevar Rao Mandava Md PC | Internal Medicine | 43171 Dalcoma Dr Ste 8, Ste 8, Clinton Township, MI 48038-6307 | 2007-11-14 |
| 1093904500 | Sentinel Wound Care Associates PC | Internal Medicine | 19697 Driftwood Dr, Clinton Township, MI 48038-6906 | 2007-10-21 |
| 1700956356 | Rudyard Limsingian Dimson | Internal Medicine | 43351 Commons Dr, Clinton Township, MI 48038-1109 | 2006-11-09 |
| 1437242914 | Regina Del Rosario Villanueva | Internal Medicine | 43361 Commons Drive, Clinton Township, MI 48038 | 2006-10-02 |
| 1417968827 | Nina Habib Rehman | Internal Medicine | 15520 19 Mile Rd Ste 480, Clinton Township, MI 48038 | 2006-08-10 |
| 1235179201 | Carl Michael Pesta Sr. | Internal Medicine | 23575 15 Mile Rd, Clinton Township, MI 48035 | 2006-06-07 |
| 1871015560 | Firdhous Alimathunis Abdul Kather | Internal Medicine | 15855 19 Mile Rd, Henry Ford Macomb Hospitals, Clinton Township, MI 48038 | 2017-07-13 |
| 1417480849 | Nimmish Khera | Internal Medicine | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2017-04-04 |
| Find all providers in CLINTON TOWNSHIP | ||||
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
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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.