PETER PONOMAREV (NPI# 1881061984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881061984 |
| Entity Type | Individual |
| Full Name | PETER PONOMAREV |
| Practice Address |
15600 W 10 Mile Rd Unit 1b Southfield MI 48075-2148 |
| Mailing Address |
2516 Black Pine Trail Dr Troy MI 48098-4102 |
| Practice Telephone | 2485697578 |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2015-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302032680 | MI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PHARMACIST LICENSE NUMBER | 5302032680 | 01 |
| Street Address |
15600 W 10 MILE RD UNIT 1B |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073363 | Menaka Ravi Chandra Reddy | Pharmacist | 23881 Greenfield Rd, Southfield, MI 48075-3122 | 2020-01-28 |
| 1013548114 | Dina Issa | Pharmacist | 26026 W 12 Mile Rd # Oad, Southfield, MI 48034-1783 | 2020-01-28 |
| 1285127290 | Hitesh P Upadhyay | Pharmacist | 23832 Southfield Rd Ste 2, Southfield, MI 48075-8001 | 2018-06-13 |
| 1558879064 | Mohamed Sohoubah | Pharmacist | 23815 Northwestern Hwy Ste 200, Southfield, MI 48075-7738 | 2018-01-18 |
| 1679967038 | Remy Onimoe | Pharmacist | 16191 Livernois Avenue, Southfield, MI 48221 | 2015-03-24 |
| 1477828457 | Eric Jeffery Lee | Pharmacist | 22277 W 12 Mile Rd, Apt 29, Southfield, MI 48034-4621 | 2012-03-09 |
| 1619240504 | Erwin H Posner | Pharmacist | 28422 Tavistock Trl, Southfield, MI 48034-2019 | 2012-02-22 |
| 1013291970 | Boby Abraham | Pharmacist | 23111 Lahser Road, Walgreens, Southfield, MI 48034 | 2011-10-10 |
| 1053694521 | Donna K Spencer | Pharmacist | 26776 W 12 Mile Rd Ste 108, Southfield, MI 48034-7807 | 2011-09-21 |
| 1518251362 | Nader Farid | Pharmacist | 21400 Northwestern Hwy, Southfield, MI 48075-5006 | 2011-06-08 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on PETER PONOMAREV.
| 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.