BIRMINGHAM SKIN & HAIR AESTHETICS PLLC (NPI# 1720524218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720524218 |
| Entity Type | Organization |
| Organization Name | BIRMINGHAM SKIN & HAIR AESTHETICS PLLC |
| Practice Address |
751 Chestnut St Suite 102 Birmingham MI 48009-6461 |
| Practice Telephone | 2485931000 |
| Mailing Telephone | 2485931000 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |
| Authorized Official Name | DR. VENKAT RUDRARAJU (OFFICIAL) |
| Authorized Official Telephone | 2485931000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4301067927 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4406149 | 05 |
| Street Address |
751 CHESTNUT ST SUITE 102 |
| City | BIRMINGHAM |
| State | MI |
| Zip Code | 48009-6461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699889618 | Carolyn S Way Dds PC | Dentist | 751 Chestnut St, Suite 103, Birmingham, MI 48009-6461 | 2006-08-18 |
| 1154935393 | Birmingham Dentistry Pllc | Dentist | 751 Chestnut St, Birmingham, MI 48009-6461 | 2020-09-04 |
| 1093088288 | Revitalize Day Spa | Massage Therapist | 751 Chestnut St, 203, Birmingham, MI 48009-6461 | 2012-02-17 |
| 1699985598 | D.c. Bonadeo, D.d.s., P.C. | Clinic/Center | 751 Chestnut St, Suite 101, Birmingham, MI 48009-6461 | 2007-05-22 |
| 1851500268 | David J Song | Dentist | 751 Chestnut St, Suite 201, Birmingham, MI 48009-6461 | 2007-05-22 |
| 1578611745 | Jerre Eugene Feinthel | Dentist | 751 Chestnut St, Suite 201, Birmingham, MI 48009-6461 | 2007-01-06 |
| 1285704205 | Jerome Raymond Branham Sr. | Dentist | 751 Chestnut St, # 104, Birmingham, MI 48009 | 2006-11-08 |
| 1578675005 | Schuyler V Hamill | Dentist | 751 Chestnut St, Suite 105, Birmingham, MI 48009-6461 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487183836 | Carolyn Joanna Archer | Dietitian, Registered | 1155 Derby Rd, Apt 3, Birmingham, MI 48009 | 2017-06-08 |
| 1912374695 | Valerie Kim Kaplansky | Counselor | 300 E. Maple Road, 315, Birmingham, MI 48009 | 2015-08-28 |
| 1578956348 | Nancy Jane Naski | Recreation Therapist | 623 Hanna St, Birmingham, MI 48009 | 2015-03-18 |
| 1619370236 | Caitlin Stoltman | Recreation Therapist | 1669 W. Maple Rd., Far, Birmingham, MI 48009 | 2014-09-28 |
| 1295140770 | Lauren Elizabeth Perlin | Obstetrics & Gynecology | 35046 Woodward Ave Ste 100, Birmingham, MI 48009 | 2014-06-24 |
| 1235560764 | Better Life Learning | Community/Behavioral Health | 33717 Woodward Ave #253, Birmingham, MI 48009 | 2013-12-10 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1689942021 | Brian Connolly Md PC | Psychiatry & Neurology | 189 Townsend, Suite 300, Birmingham, MI 48009 | 2011-12-13 |
| 1619204187 | Dr. Lori PC | Dermatology | 353 South Old Woodward Ave, Birmingham, MI 48009 | 2009-11-04 |
| 1033348453 | Jason Eric Gregory | Music Therapist | 1669 West Maple, Birmingham, MI 48009 | 2009-07-07 |
| Find all providers in zip 48009 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639154 | Grace Blane Mcmahan | Physician Assistant | 972 Montclair Rd Ste 100, Birmingham, AL 35213-1203 | 2019-10-08 |
| 1780247692 | Rachel Anne Stallman | Physician Assistant | 601 S 19th Street, Birmingham, AL 35294-0001 | 2019-04-16 |
| 1457975286 | Kenna Kuehn | Physician Assistant | 619 19th St S Ste P915, Birmingham, AL 35233-1900 | 2020-06-08 |
| 1578198818 | Isabelle Kallenberg | Physician Assistant | 620 19th St S, Birmingham, AL 35233 | 2020-03-06 |
| 1578194270 | Erin Margaret Dorman | Physician Assistant | 619 19th St S Ste P915, Birmingham, AL 35233-1900 | 2020-01-31 |
| 1255979225 | Tyler James Lacoste | Physician Assistant | 1201 11th Ave S, Birmingham, AL 35205-3423 | 2019-12-20 |
| 1659913713 | Anna Pierce Ireland | Physician Assistant | 619 19th St S, Birmingham, AL 35249-1900 | 2019-10-10 |
| 1174164255 | Andrew Parker Bartran | Physician Assistant | 1802 6th Ave S, Birmingham, AL 35233-1932 | 2019-09-30 |
| 1982160719 | Itia Dowdell | Physician Assistant | 2000 6th Ave S, Birmingham, AL 35233-2110 | 2019-02-18 |
| 1447716766 | Jessica Maria Mena | Physician Assistant | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2019-02-11 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 48009 |
Please comment or provide details below to improve the information on BIRMINGHAM SKIN & HAIR AESTHETICS PLLC.
| 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.