PARK PLACE VEIN CENTER (NPI# 1831129055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831129055 |
| Entity Type | Organization |
| Organization Name | PARK PLACE VEIN CENTER |
| Practice Address |
47601 Grand River Ave Suite A-110 Novi MI 48374-1233 |
| Mailing Address |
3802 Spanish Oaks Dr West Bloomfield MI 48323-1859 |
| Practice Telephone | 2484654762 |
| Mailing Telephone | 2484654762 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALAN BRYAN NEWMAN (OWNER) |
| Authorized Official Telephone | 2484654762 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | AN 067888 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4495597 | 05 |
| Street Address |
47601 GRAND RIVER AVE SUITE A-110 |
| City | NOVI |
| State | MI |
| Zip Code | 48374-1233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265431696 | Colleen Larose Miele | Pediatrics | 47601 Grand River Ave, B233, Novi, MI 48374-1233 | 2005-07-19 |
| 1821610478 | Harjot Gill | Physician Assistant | 47601 Grand River Ave, Novi, MI 48374-1233 | 2020-05-16 |
| 1417578147 | Sean Patrick Hohl | Registered Nurse | 47601 Grand River Ave, Novi, MI 48374-1233 | 2020-05-05 |
| 1952946972 | Adam C Donnellon | Physician Assistant | 47601 Grand River Ave, Novi, MI 48374-1233 | 2019-11-13 |
| 1508412826 | Kathleen Ruffolo | Nurse Practitioner | 47601 Grand River Ave, Novi, MI 48374-1233 | 2019-08-13 |
| 1073167532 | Candace Lee Hogrefe | Nurse Anesthetist, Certified Registered | 47601 Grand River Ave, Novi, MI 48374 | 2019-08-01 |
| 1134780794 | Taylor Garland | Physician Assistant | 47601 Grand River Ave, Novi, MI 48374-1233 | 2019-06-25 |
| 1881253375 | Alessandra Vincenza Palazzolo | Internal Medicine | 47601 Grand River Ave, Novi, MI 48374-1233 | 2019-06-10 |
| 1598238172 | Lisa Hydorn | Nurse Anesthetist, Certified Registered | 47601 Grand River Ave, Novi, MI 48374-1233 | 2019-01-07 |
| 1558863365 | Jocelyn Cartujano Baisa | Physical Therapist | 47601 Grand River Ave, Novi, MI 48374-1233 | 2018-03-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902323884 | Jhansi Navuluri | Physical Therapist | 27579 Etrada Lane, Novi, MI 48374 | 2017-08-23 |
| 1609306422 | James Vanderhaeghen | Foster Care Agency | 24375 Homestead Ct, Novi, MI 48374 | 2017-06-14 |
| 1558810622 | Iryna Chaykivska | Nurse Anesthetist, Certified Registered | 47601 Grand River Avenue, Novi, MI 48374 | 2016-09-29 |
| 1477937944 | Joseph Smola | Chiropractor | 48000 Grand River Ave, Novi, MI 48374 | 2015-07-15 |
| 1881005114 | Alpha Medical Services PC | Internal Medicine | 26131, Sunbury Ct, Novi, MI 48374 | 2014-05-08 |
| 1043565443 | Jason J Rizqallah | Surgery | 47601 Grand River Ave # B136, Novi, MI 48374 | 2012-07-21 |
| 1780992628 | Khyati Patel | Internal Medicine | 26850 Providence Pkwy Ste 420, Novi, MI 48374 | 2010-09-14 |
| 1891963799 | Luann Marie Redmond | Social Worker | 50598 Montana, Novi, MI 48374 | 2008-02-13 |
| 1427249424 | Ajay V Raman | Anesthesiology | 24875 Novi Road #454, Novi, MI 48374 | 2007-08-05 |
| 1003948233 | Sam's Club Optical | Technician/Technologist | 27300 Wixon Road, Novi, MI 48374 | 2007-03-12 |
| Find all providers in zip 48374 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407210883 | Amanda Nicole King | Obstetrics & Gynecology | 46325 W 12 Mile Rd Ste 250, Novi, MI 48377-2461 | 2016-04-11 |
| 1740228279 | Deirdre A Wickham | Obstetrics & Gynecology | 39475 Lewis Dr Ste 270, Novi, MI 48377-2904 | 2006-06-04 |
| 1699746537 | Women's Health Consultants, Plc | Obstetrics & Gynecology | 46325 W 12 Mile Road, Suite 250, Novi, MI 48377 | 2006-01-30 |
| 1740275130 | Karol L Otteman | Obstetrics & Gynecology | 27780 Novi Rd, Suite 108, Novi, MI 48377-3401 | 2005-09-13 |
| 1659372118 | Lester James Voutsos | Obstetrics & Gynecology | 46325 W Twelve Mile Road, Suite 250, Novi, MI 48377 | 2005-08-09 |
| 1851399919 | Paul Hakim | Obstetrics & Gynecology | 26850 Providence Parkway, Suite 500, Novi, MI 48374 | 2005-07-13 |
| 1750388930 | Jennifer Ilene Kaplan | Obstetrics & Gynecology | 46325 W. Twelve Mile Road, Suite 250, Novi, MI 48377 | 2005-07-05 |
| 1861805590 | Emily Caitlin Zajac | Obstetrics & Gynecology | 39475 Lewis Dr Ste 270, Novi, MI 48377-2904 | 2014-06-10 |
| 1982029344 | Virginia Battel | Obstetrics & Gynecology | 46325 W 12 Mile Rd, Suite 250, Novi, MI 48377-2456 | 2014-02-21 |
| 1740542141 | Jennifer Debra Borson | Obstetrics & Gynecology | 46325 W 12 Mile Rd, Suite 250, Novi, MI 48377-2456 | 2012-06-12 |
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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.