DETROIT MEDICAL CENTER (NPI# 1861621534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861621534 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Practice Address |
3990 John R St Box162 Detroit MI 48201-2018 |
| Practice Telephone | 3137457233 |
| Mailing Telephone | 3137457233 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |
| Authorized Official Name | DR. RUDRAM NAIDU MUPPURI (RESIDENT) |
| Authorized Official Telephone | 3136630023 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NW0100X |
General Acute Care Hospital Specialization: Women |
Hospitals | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1619332574 | Detroit Medical Center | Clinic/Center | 43205 Creekview Dr, Canton, MI 48187-3049 | 2015-12-19 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1326279803 | Detroit Medical Center | Special Hospital | 39180 Citation Pl, Apt # 35104, Farmington Hills, MI 48331-4901 | 2009-08-02 |
| 1356510085 | Detroit Medical Center | Clinic/Center | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2008-02-27 |
| 1699327429 | Detroit Medical Center | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2019-07-11 |
| 1205178761 | Detroit Medical Center | Psychiatry & Neurology | 3901 Beaubien St, Department of Neurology, Children's Hospital of Michiga, Detroit, MI 48201-2119 | 2013-03-22 |
| 1346508157 | Detroit Medical Center | Special Hospital | 4160 John R St, Detroit, MI 48201-2020 | 2012-04-30 |
| 1770853251 | Detroit Medical Center | Emergency Medicine | 6071 W Outer Dr, Emergency Medicine Department, Detroit, MI 48235-2624 | 2011-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DETROIT MEDICAL CENTER | 3990 John R St, Detroit, MI 48201-2018 |
| Street Address |
3990 JOHN R ST BOX162 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619959707 | Candice Garwood | Pharmacist | 3990 John R St, Department of Pharmacy, Detroit, MI 48201-2018 | 2005-11-15 |
| 1396342085 | Tzu-bou Hsieh | Obstetrics & Gynecology | 3990 John R St, Detroit, MI 48201-2018 | 2020-10-06 |
| 1558976928 | Ashley Mary Asmar | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2020-09-12 |
| 1871102574 | Adam Ryan Mills | Registered Nurse | 3990 John R St, Detroit, MI 48201-2018 | 2020-07-28 |
| 1033734082 | Sean Lang | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-06-15 |
| 1568084259 | Carly Victoria Burns | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-05-15 |
| 1154941805 | Dustin David Reykdal | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1902426513 | Merva N. Gilani | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1659991271 | Elisabeth Lederman Wong | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1366080640 | Joel David Ziettlow | Nurse Anesthetist, Certified Registered | 3990 John R St, Detroit, MI 48201-2018 | 2019-12-17 |
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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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1346511151 | Sara Goldgraben | General Acute Care Hospital | 540 E. Canfield, Department of Radiation Oncology, Detroit, MI 48201 | 2012-01-25 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1922239920 | Wayne State University/detroit Medical Center | General Acute Care Hospital | 4201 Saint Antoine St # 2e, Detroit, MI 48201-2153 | 2009-08-07 |
| 1710134010 | Tetsuhiro Higashida | General Acute Care Hospital | 4201 St. Antoine Suite 6e, Detroit, MI 48201 | 2008-08-19 |
| 1487792818 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virgina Park, Detroit, MI 48202 | 2007-02-01 |
| 1134266687 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virginia Park, Detroit, MI 48202 | 2007-01-31 |
| 1669400305 | Ltac Hospital Detroit, LLC | General Acute Care Hospital | 801 Virginia Park St, Third Floor, Detroit, MI 48202-1925 | 2006-06-29 |
| 1043755788 | Barbara Ann Karmanos Cancer Center | General Acute Care Hospital | 4100 John R St, Detroit, MI 48201-2013 | 2017-01-05 |
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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.