DR. DONALD GEORGE PETHTEL (NPI# 1851340814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851340814 |
| Entity Type | Individual |
| Full Name | DR. DONALD GEORGE PETHTEL |
| Credential | D.C. |
| Practice Address |
23610 Van Born Rd Dearborn Heights MI 48125-2356 |
| Practice Telephone | 3132911060 |
| Practice Fax Number | 3132911089 |
| Mailing Telephone | 3132911060 |
| Mailing Fax Number | 3132911089 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2008-12-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301008389 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS MI | 950H25427 | 01 |
| MI | BCBS MI | 0H25427 | 01 |
| MI | PREFERRED CHIOCES | 140344 | 01 |
| MI | 144298355 | 05 | |
| MI | BLUECARE NETWORK | P112080 | 01 |
| MI | HAP | U84613 | 01 |
| Street Address |
23610 VAN BORN RD |
| City | DEARBORN HEIGHTS |
| State | MI |
| Zip Code | 48125-2356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760431977 | Renee Irene Pethtel | Chiropractor | 23610 Van Born Rd, Dearborn Heights, MI 48125-2356 | 2006-05-08 |
| 1356477897 | David Daniel Grant | Chiropractor | 23610 Van Born Rd, Dearborn Heights, MI 48125-2356 | 2007-02-26 |
| 1821047861 | Van Born Chiropractic Clinic, P.C. | Chiropractor | 23610 Van Born Rd, Dearborn Heights, MI 48125-2356 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063071637 | Smart Rx LLC | Pharmacy | 25464 Van Born Rd, Dearborn Heights, MI 48125 | 2019-06-07 |
| 1558811331 | Jacquelyn Elyoussef | Technician, Other | 3930 Academy St, Dearborn Heights, MI 48125 | 2016-10-05 |
| 1386856375 | Amerigard Development Corporation | Family Medicine | 23850 Van Born Road, Dearborn Heights, MI 48125 | 2007-05-04 |
| 1922140490 | Marie C Petricca | Social Worker | 20382 Van Born Road, Catholic Social Services of Wayne County, Dearborn Heights, MI 48125 | 2007-02-13 |
| 1528025871 | David L Cooley | Family Medicine | 3902 Monroe, Dearborn Heights, MI 48125 | 2006-04-28 |
| 1013998251 | Masha-moss Inc | Pharmacy | 4245 S Beech Daly Rd, Dearborn Heights, MI 48125 | 2005-11-06 |
| 1033639109 | Clinic Rx 2 LLC | Pharmacy | 23850 Van Born Rd, Dearborn Heights, MI 48125 | 2017-06-21 |
| 1932639176 | Olivia J. Furnas | Midwife | 18101 Oakwood Blvd, Dearborn, MI 48125 | 2017-06-19 |
| 1083099303 | Holistic Healer Health Coaching LLC | Nutritionist | 3998 Clippert St, Dearborn Heights, MI 48125 | 2015-07-28 |
| 1396255915 | Lillian Drushelia Herzberg | Registered Nurse | 26827 Annapolis St, Dearborn Hts, MI 48125-1201 | 2017-10-10 |
| Find all providers in zip 48125 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770034308 | Ashlea Raylene Clark | Chiropractor | 6569 N Evangeline St, Dearborn Heights, MI 48127-2030 | 2016-10-19 |
| 1679995401 | Mohamed Raychouni | Chiropractor | 22030 Ford Rd Ste B, Dearborn Heights, MI 48127-2418 | 2014-01-14 |
| 1174868467 | Radwan Khazaal | Chiropractor | 22030 Ford Rd, Suite B, Dearborn Heights, MI 48127-2418 | 2012-11-28 |
| 1144485715 | Kevin Delaney Kreger | Chiropractor | 23420 Ford Rd Ste 2, Dearborn Heights, MI 48127-2396 | 2008-07-23 |
| 1093985475 | Majed Hamadeh | Chiropractor | 6919 N. Waverly Street, Dearborn Heights, MI 48127 | 2008-03-03 |
| 1396914388 | Jennifer Lynn Kelly | Chiropractor | 8240 N Telegraph Rd, Dearborn Heights, MI 48127-1435 | 2008-02-25 |
| 1033267703 | Kenneth Hughes | Chiropractor | 25210 Ford Rd, Dearborn Heights, MI 48127-4818 | 2007-01-08 |
| 1407894843 | Glenn A Caudell | Chiropractor | 5928 N Telegraph Rd, Dearborn Heights, MI 48127-3221 | 2006-06-04 |
| 1316985567 | Naiel Salameh | Chiropractor | 22243 W Warren St, Dearborn Heights, MI 48127-2531 | 2006-06-02 |
| 1760431977 | Renee Irene Pethtel | Chiropractor | 23610 Van Born Rd, Dearborn Heights, MI 48125-2356 | 2006-05-08 |
| Find all providers in DEARBORN HEIGHTS | ||||
| City | DEARBORN HEIGHTS |
| Zip Code | 48125 |
Please comment or provide details below to improve the information on DR. DONALD GEORGE PETHTEL.
| 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.