PHYSICIAN HEALTHCARE NETWORK, PC (NPI# 1750334405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750334405 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN HEALTHCARE NETWORK, PC |
| Practice Address |
3050 Commerce Dr Billing and Administration Fort Gratiot MI 48059-3819 |
| Practice Telephone | 8103854441 |
| Practice Fax Number | 8103851540 |
| Mailing Telephone | 8103854441 |
| Mailing Fax Number | 8103851540 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-03-28 |
| Authorized Official Name | DENISE KLIEMAN (COO) |
| Authorized Official Telephone | 8103858082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
========= | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 291U00000X | Clinical Medical Laboratory | 23D0364244 | MI | Laboratories |
| N | 207P00000X | Emergency Medicine | ========= | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | ========= | Allopathic & Osteopathic Physicians | |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
========= | Allopathic & Osteopathic Physicians | |
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
========= | Allopathic & Osteopathic Physicians | |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
========= | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | ========= | Allopathic & Osteopathic Physicians | |
| N | 208M00000X | Hospitalist | ========= | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | ========= | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
========= | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
========= | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | ========= | Allopathic & Osteopathic Physicians | |
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NPI | 1750334405 | 01 |
| MI | BLUECROSS BLUESHIELD | 700G460400 | 01 |
| PALMETTO RAILROAD MEDICARE | CN1572 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295941375 | Physician Healthcare Network, PC | Clinic/Center | 10127 Marine City Hwy, Ira, MI 48023-1008 | 2007-05-15 |
| 1639385784 | Physician Healthcare Network, PC | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2007-05-15 |
| 1093921074 | Physician Healthcare Network, PC | Clinic/Center | 3350 Gratiot Blvd, Marysville, MI 48040-2121 | 2007-05-15 |
| 1245445972 | Physician Healthcare Network, PC | Clinic/Center | 1641 10th St, Port Huron, MI 48060-5844 | 2007-05-14 |
| Street Address |
3050 COMMERCE DR BILLING AND ADMINISTRATION |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059-3819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437125457 | Vil Edward Matro Castillo | Hospitalist | 3050 Commerce Dr, Suite C, Fort Gratiot, MI 48059-3819 | 2006-02-28 |
| 1396392221 | Kelly Grevemeyer | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2019-08-26 |
| 1831677384 | Krystal Ziolkowski | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2018-08-06 |
| 1871082461 | Shannon Oehmke | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2018-05-09 |
| 1780138172 | Latonia Young | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2016-08-15 |
| 1184178840 | Karen Wheeler | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2016-08-11 |
| 1881067767 | Colleen Dewan | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2015-11-02 |
| 1114317385 | Lori Gabriel | Registered Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2015-01-27 |
| 1720478902 | Gloria Shurkey | Licensed Practical Nurse | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2015-01-27 |
| 1316361967 | Deepa Nandamudi | Social Worker | 3050 Commerce Dr, Fort Gratiot, MI 48059-3819 | 2014-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1396756615 | Blue Water Family Dentistry PC | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059 | 2006-08-11 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| Find all providers in zip 48059 | ||||
| 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 |
|---|---|---|---|---|
| 1427693761 | Horizon Family Medicine Pllc | Family Medicine | 3041 Commerce Dr Ste B, Fort Gratiot, MI 48059-3877 | 2019-11-11 |
| 1770126211 | Aleesha Smith | Family Medicine | 4430 Carrigan Rd, Fort Gratiot, MI 48059-2904 | 2019-10-28 |
| 1437125473 | Jude L Stratford | Family Medicine | 3903 Stoney Ridge Dr, Fort Gratiot, MI 48059-3761 | 2006-02-28 |
| 1750379194 | G Blair Dowden IIi | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2005-10-10 |
| 1114222031 | Lighthouse Family Medicine, Pllc | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2011-01-25 |
| 1285749549 | Julie A Boutt | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2006-08-20 |
| 1316914245 | Christopher J Borgiel | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-02-28 |
| 1225004252 | Daniel C Souphis | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-02-28 |
| 1053399642 | Farrukh Zaman Naqvi | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-01-04 |
| 1700862935 | Lavi Rohatgi | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2005-12-20 |
| Find all providers in FORT GRATIOT | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
Please comment or provide details below to improve the information on PHYSICIAN HEALTHCARE NETWORK, PC.
| 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.