DELTA FAMILY CLINIC SOUTH PC (NPI# 1902162746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902162746 |
| Entity Type | Organization |
| Organization Name | DELTA FAMILY CLINIC SOUTH PC |
| Other Organization Name | DELTA FAMILY CLINIC |
| Practice Address |
901 N. Euclid Ave. Bay City MI 48706 |
| Mailing Address |
6195 Miller Rd. Ste. A Swartz Creek MI 48473 |
| Practice Telephone | 9896719798 |
| Mailing Telephone | 8106301152 |
| Mailing Fax Number | 8106309107 |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-04-05 |
| Authorized Official Name | GERARD WILLIAMS (CFO/ ADNIMISTRATOR) |
| Authorized Official Telephone | 8106301152 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | Y |
| Parent Organization Name | DELTA FAMILY CLINIC SOUTH P.C |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Delta Family Clinic | Doing Business As Name - Organization |
| Street Address |
901 N. EUCLID AVE. |
| City | BAY CITY |
| State | MI |
| Zip Code | 48706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574357 | Kalie Keyes | Behavior Technician | 3710 Katalin Ct, Bay City, MI 48706 | 2020-10-06 |
| 1790251049 | Leann Marie Miller | Nurse Practitioner | Visiting Physicians Association, 1484 Straits Drive, Bay City, MI 48706 | 2018-10-15 |
| 1659883676 | Matthew Zamora | Internal Medicine | 4818 S Professional Dr, Bay City, MI 48706 | 2017-10-31 |
| 1376082230 | Deidre Dotson | Social Worker | 1217 S Euclid, Bay City, MI 48706 | 2017-02-13 |
| 1790100717 | Kochar Plc | Internal Medicine | 4817 E. Professional Drive, Bay City, MI 48706 | 2014-02-27 |
| 1992136477 | Janelle Gale Ballard | Music Therapist | 4106 Wilder Rd, Bay City, MI 48706 | 2013-12-09 |
| 1619319084 | Jessica T Jang | Veterinarian | 6015 West Side Saginaw Rd, Bay City, MI 48706 | 2013-07-25 |
| 1427493634 | Cynthia Marie Bordeau | Social Worker | 1217 S. Euclid, Bay City, MI 48706 | 2013-05-01 |
| 1669762985 | James Norbert Stachowski | Pharmacist | 3880 Wilder, Bay City, MI 48706 | 2011-04-08 |
| 1841501863 | Venkata Sai Sheshu Kumar Etha | Physical Medicine & Rehabilitation | 3190 East Midland Road, Bay City, MI 48706 | 2010-06-24 |
| Find all providers in zip 48706 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598803215 | Edward Charles Podany | Psychologist | 5958 Red Feather Dr, Bay City, MI 48706-3490 | 2007-02-02 |
| 1407909534 | Gary R West | Psychologist | 200 S Wenona St Ste 280, Bay City, MI 48706-8845 | 2007-01-20 |
| 1740395961 | Doris Elaine Shmina | Psychologist | 2355 Delta Rd, Bay City, MI 48706-9340 | 2006-08-20 |
| 1306341987 | Debra A Mayhew | Psychologist | 201 Mulholland St, Bay City, MI 48708-7693 | 2018-03-27 |
| 1215035357 | Tammie Fogal | Psychologist | 114 Tuscola, Bay City, MI 48708-6995 | 2006-09-20 |
| 1912012063 | David Mark Waldman | Psychologist | 201 Mulholland St, Bay City, MI 48708-7693 | 2006-08-20 |
| 1770698094 | George Mason | Psychologist | 201 Mulholland St, Bay City, MI 48708-7693 | 2006-08-19 |
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|---|---|---|---|---|
| 1245831296 | Reema S. Beri, Phd, LLC | Psychologist | 49410 Waterstone Estates Cir, Northville, MI 48168-4900 | 2020-11-05 |
| 1952901225 | Northerner Psychological Services, Pllc | Psychologist | 1869 Melbourne St, Birmingham, MI 48009-1160 | 2020-10-27 |
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1952900037 | Jamila Simone Steward | Psychologist | 31275 Northwestern Hwy Ste 216, Farmington Hills, MI 48334-2570 | 2020-10-20 |
| 1992303465 | Madison Bryant | Psychologist | 1231 S Cass Lake Rd, Waterford, MI 48328-4739 | 2020-10-15 |
| 1730787664 | Athal Yako | Psychologist | 18230 Teresa Dr, Macomb, MI 48044-1681 | 2020-10-13 |
| 1538767678 | Up Telehealth, LLC | Psychologist | 228 W Washington St Ste 7, Marquette, MI 49855-4330 | 2020-10-12 |
| 1881292076 | Meaningful Change: Clinical & Consultation Psychology, Pllc | Psychologist | 1861 Woodland Dr, Mount Pleasant, MI 48858-1298 | 2020-10-11 |
| 1902404122 | Dorrean Riley | Psychologist | 19189 Lexington, Redford, MI 48240-2618 | 2020-10-09 |
| 1174130850 | Timber Creek Counseling West LLC | Psychologist | 2976 Ivanrest Ave Sw Ste 215, Grandville, MI 49418-1440 | 2020-09-28 |
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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.