GENESEE CANCER AND BLOOD DISEASE TREATMENT CENTER PC (NPI# 1912068453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912068453 |
| Entity Type | Organization |
| Organization Name | GENESEE CANCER AND BLOOD DISEASE TREATMENT CENTER PC |
| Practice Address |
302 Kensington Ave Flint MI 48503 |
| Practice Telephone | 8107628400 |
| Practice Fax Number | 8107628116 |
| Mailing Telephone | 8107628400 |
| Mailing Fax Number | 8107628118 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | RIZWAN DANISH (OFFICE PRESIDENT) |
| Authorized Official Telephone | 8107628400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MI | Allopathic & Osteopathic Physicians |
| Street Address |
302 KENSINGTON AVE |
| City | FLINT |
| State | MI |
| Zip Code | 48503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891782736 | James Ewell Graham Jr. | Obstetrics & Gynecology | 302 Kensington Ave, Genesys Hurley Cancer Institute, Flint, MI 48503-2044 | 2005-10-05 |
| 1831797638 | Kristin Dunaway | Nurse Practitioner | 302 Kensington Ave, Flint, MI 48503-2044 | 2020-10-14 |
| 1093285496 | Christopher M Jackson | Nurse Practitioner | 302 Kensington Ave, Flint, MI 48503-2044 | 2018-11-28 |
| 1992246904 | Larsen Medical Plc | Surgery | 302 Kensington Ave, Flint, MI 48503-2044 | 2017-03-10 |
| 1467801985 | Collaborative Radiation Oncology Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2016-06-06 |
| 1942612577 | Amy Jiries Calati | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2014-06-02 |
| 1104161363 | Dong Whan Oh Md Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2012-11-29 |
| 1124362272 | Haesook S Kim Md Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2012-11-15 |
| 1962795013 | Sirisha Manyam | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2011-05-24 |
| 1588971261 | Anne Marie Cox | Dietitian, Registered | 302 Kensington Ave, Flint, MI 48503-2044 | 2010-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962795013 | Sirisha Manyam | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2011-05-24 |
| 1699956938 | M M Khoulani Md PC | Internal Medicine | 5080 Villa Linde Pkwy, Unit 4, Flint, MI 48532-3423 | 2007-11-15 |
| 1932315124 | Sandeep S Grewal | Internal Medicine | 4100 Beecher Rd, Ste B, Flint, MI 48532-3661 | 2007-05-15 |
| 1588783963 | Venkatasiva Peram Md, PC | Internal Medicine | 2222 S Linden Rd, Suite G, Flint, MI 48532-5475 | 2007-03-28 |
| 1902977101 | Genesee Hematology-oncology, P.C. | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2006-11-11 |
| 1881617702 | Venkatasiva Reddy Peram | Internal Medicine | 2222 S Linden Rd, Ste # G, Flint, MI 48532-5475 | 2006-07-25 |
| 1003852856 | Mohamad Monir Khoulani | Internal Medicine | 5080 Villa Linde Pkwy, Unit 4, Flint, MI 48532-3411 | 2006-06-21 |
| 1538105564 | Singh & Arora Oncology Hematology P C | Internal Medicine | 4100 Beecher Rd, Ste B, Flint, MI 48532-3605 | 2006-06-20 |
| 1700823705 | David Stuart Eilender | Internal Medicine | 4100 Beecher Rd, Ste. B, Flint, MI 48532-3661 | 2006-05-31 |
| 1477518629 | Khalil A. Katato | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2006-04-19 |
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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.