DR. VINOD K MISRA (NPI# 1861402497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861402497 |
| Entity Type | Individual |
| Full Name | DR. VINOD K MISRA |
| Credential | MD PHD |
| Practice Address |
3950 Beaubien St Detroit MI 48201-2120 |
| Practice Telephone | 7348329122 |
| Mailing Telephone | 7348329122 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2012-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
4301079084 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 4301079084 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4572490 | 05 |
| Street Address |
3950 BEAUBIEN ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588656615 | Friendship Manor Nursing Home | Skilled Nursing Facility | 3950 Beaubien St, Detroit, MI 48201-2120 | 2005-08-16 |
| 1316573603 | Shivani Sanjay Rami | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2166 | 2020-03-18 |
| 1578056610 | Jessica Mcelfresh | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-06-13 |
| 1326530767 | Lauren Jeffery | Occupational Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-06-01 |
| 1225520984 | India Rahel Stanford | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-30 |
| 1790276590 | Allison Lewsley | Occupational Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-29 |
| 1104317932 | Margaret A Johnson | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-29 |
| 1508357302 | Laura Kay Klein | Occupational Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-29 |
| 1619468410 | Melissa Ann Hambright | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-29 |
| 1033600853 | Donna Dotson | Physical Therapist | 3950 Beaubien St, Detroit, MI 48201-2120 | 2018-05-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699712174 | Gerald L. Feldman | Medical Genetics | 3950 Beaubien St Fl 3, Children's Hospital of Michigan, Detroit, MI 48201-2120 | 2006-06-01 |
| 1912944919 | Erawati Vishwas Bawle | Medical Genetics | 3901 Beaubien Blvd, Children's Hospital of Michigan, Div of Genetics., Detroit, MI 48201-2061 | 2006-05-31 |
| 1750732590 | Stephanie Campbell | Medical Genetics | 3901 Beaubien St, Detroit, MI 48201-2119 | 2016-06-22 |
| 1518157510 | Robert L Conway | Medical Genetics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2007-07-26 |
| 1326250564 | Leigh Flore | Medical Genetics | 3901 Beaubien, Children's Hospital of Mi, Detroit, MI 48201 | 2007-05-03 |
| 1073680443 | Mary Helen Quigg | Medical Genetics | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-11-29 |
| 1982771358 | Jacquelyn R. Roberson | Medical Genetics | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568721850 | Timothy Moss | Medical Genetics | 25 Michigan St Ne Ste 2000, Grand Rapids, MI 49503-2526 | 2012-05-08 |
| 1679869143 | Stacie Diane Adams | Medical Genetics | 4660 S Hagadorn Rd Ste 405, East Lansing, MI 48823 | 2011-06-23 |
| 1497960397 | Allison Meredith Jay | Medical Genetics | 19229 Mack Ave Ste 18, Grosse Pointe Woods, MI 48236-2857 | 2007-05-14 |
| 1134133762 | Andrea Amalfitano | Medical Genetics | 1600 W Grand River Ste 2, Okemos, MI 48864 | 2006-07-28 |
| 1427411131 | Linda Zhong Rossetti | Medical Genetics | 25 Michigan St Ne Ste 2000, Grand Rapids, MI 49503-2526 | 2016-03-30 |
| 1609256064 | Elizabeth Grace Ames | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2015-06-01 |
| 1932519253 | Kristen Nicole Lee | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-05-08 |
| 1194067470 | Amanda Barone Pritchard | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-03-25 |
| 1184934291 | Spectrum Health Hospitals | Medical Genetics | 25 Michigan St Ne, Suite 2000, Grand Rapids, MI 49503-2515 | 2010-10-08 |
| 1124353727 | Michigan Spine and Brain Institute PC | Medical Genetics | 5400 Mackinaw Rd, Suite 2300, Saginaw, MI 48604-9515 | 2009-10-15 |
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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.