DR. FIDELINA NITURA BARACEROS (NPI# 1841234622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841234622 |
| Entity Type | Individual |
| Full Name | DR. FIDELINA NITURA BARACEROS |
| Credential | MD |
| Practice Address |
43750 Woodward Ave Ste 104 Bloomfield Hills MI 48302-5063 |
| Practice Telephone | 2483346000 |
| Practice Fax Number | 2483348740 |
| Mailing Telephone | 2483346000 |
| Mailing Fax Number | 2483348740 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | FB035468 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MERCY HEALTH PLAN ID # | 101152 | 01 |
| MI | 195380310 | 05 | |
| MI | STATE LIC NUMBER | FB035468 | 01 |
| MI | BCBS PROV ID # | 3506341231 | 01 |
| Street Address |
43750 WOODWARD AVE STE 104 |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48302-5063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245657626 | Manoj Jeevanandam | Physical Therapist | 43750 Woodward Ave, Suite 103, Bloomfield Hills, MI 48302-5063 | 2014-03-24 |
| 1073826301 | Katherine Jean Valmores Yulo | Pediatrics | 43750 Woodward Ave, Bloomfield Hills, MI 48302-5063 | 2010-07-15 |
| 1154510220 | Stride Physical Therapy Inc. | Clinic/Center | 43750 Woodward Ave, Suite 103, Bloomfield Hills, MI 48302-5063 | 2007-10-15 |
| 1346361946 | Bloomfield Hills Pediatrics | Specialist | 43750 Woodward Ave, Ste 104, Bloomfield Hills, MI 48302-5063 | 2007-04-02 |
| 1639220890 | Veena Govila Md PC | Internal Medicine | 43750 Woodward Ave, Suite 103, Bloomfield Hills, MI 48302-5063 | 2007-01-15 |
| 1013076900 | Veena Govila | Internal Medicine | 43750 Woodward Ave, Suite 102, Bloomfield Hills, MI 48302-5063 | 2006-12-06 |
| 1093792582 | Vijay Saigal | Internal Medicine | 43750 Woodward Ave, Ste 101, Bloomfield Hills, MI 48302 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242634 | Lamuriel Lewis | Registered Nurse | 1430 South Telegraph Rd, Bloomfield Hills, MI 48302 | 2020-10-09 |
| 1730794082 | Ola Glezen | Registered Nurse | 1410 South Telegraph Road, Bloomfield Hills, MI 48302 | 2020-09-14 |
| 1114563400 | Henry Ford Health System | Pharmacy | 1961 S Telegraph Rd, Bloomfield Twp, MI 48302 | 2019-11-21 |
| 1508407982 | P-cor LLC | Eyewear Supplier (Equipment, not the service) | 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 | 2019-10-07 |
| 1144887936 | Christine Beth Wilson De Medina | Psychologist | W-4111 Andover Road, Bloomfield Hills, MI 48302 | 2019-05-28 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1306398078 | Shaleene Mayo | Mechanotherapist | 43902 Woodward # 120, Bloomfield Hills, MI 48302 | 2016-10-28 |
| 1588112981 | Carol Van Kampen | Social Worker | 2550 S. Telegraph, Bloomfield Hills, MI 48302 | 2016-09-14 |
| 1770933848 | Rachelle Savalli | Family Medicine | 1961 South Telegraph Rd, Bloomfield Twp, MI 48302 | 2016-06-20 |
| 1699155366 | Aleksey Mishulin | Ophthalmology | 1750 S Telegraph Ste 205, Bloomfield Hills, MI 48302 | 2015-06-08 |
| Find all providers in zip 48302 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598900896 | Niru Prasad | Pediatrics | 264 Pine Ridge Dr, Bloomfield Hills, MI 48304-2137 | 2008-12-16 |
| 1770604928 | Preeti Thabolingam | Pediatrics | 43750 Woodward Ste 104, Bloomfield Hills, MI 48302-5063 | 2007-04-03 |
| 1134292469 | Poonam Goel | Pediatrics | 3072 Woodcreek Way, Bloomfield Hills, MI 48304-1862 | 2006-11-16 |
| 1285678730 | Alita Rene Rice | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2006-06-15 |
| 1215937925 | Stanford Alvin Singer | Pediatrics | 36700 Woodward Ave, Ste 300, Bloomfield Hills, MI 48304-0926 | 2005-07-22 |
| 1437157955 | Sonja M Earles | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2005-07-08 |
| 1508358896 | Tara Elizabeth Kristock | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2018-06-01 |
| 1669922977 | Serenity Pediatrics | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2016-10-11 |
| 1245650043 | Simi Pullukat | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2014-04-18 |
| 1073826301 | Katherine Jean Valmores Yulo | Pediatrics | 43750 Woodward Ave, Bloomfield Hills, MI 48302-5063 | 2010-07-15 |
| Find all providers in BLOOMFIELD HILLS | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48302 |
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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.