DR. RUDY JEROME VERVAEKE


Address: 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607
Phone: 5867757400

DR. RUDY JEROME VERVAEKE (NPI# 1922108927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922108927
Entity Type Individual
Full Name DR. RUDY JEROME VERVAEKE
Credential M.D.
Practice Address 21420 Harper Ave
Suite 2
Saint Clair Shores
MI 48080-3607
Practice Telephone 5867757400
Practice Fax Number 5867750091
Mailing Telephone 5867757400
Mailing Fax Number 5867750091
Enumeration Date 2006-09-22
Last Update Date 2015-11-20
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RA0401X Internal Medicine
Specialization: Addiction Medicine
4301044898 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI COMMERCIAL 352263519 01
MI 4842512-10 05
MA BLUE CROSS BLUE SHIELD 1105018171 01

Office Location

Street Address 21420 HARPER AVE
SUITE 2
City SAINT CLAIR SHORES
State MI
Zip Code 48080-3607

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942300884 Southeastern Michigan Medical Consultants PC Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22
1558461426 Bharat Kumar Patel Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22
1083714976 Bharat Patel M.d. PC Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508482084 Farrah Aleema Rajab Family Medicine 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 2020-06-22
1558986141 Julia Anastazja Krakowska Family Medicine 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 2020-06-10
1972073567 Joyce Stepnak Social Worker 19611 E. 8 Mile Rd, Scs, MI 48080 2018-11-27
1487134177 Bonnie Girson Social Worker 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 2018-08-21
1609309913 Park Pharmacy Scs LLC Pharmacy 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 2017-04-05
1730564055 Mary Rose Giroux Psychologist 22516 Overlake St, St. Clair Shores, MI 48080 2015-07-28
1962882910 Ali Tarif Bazzy Family Medicine 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 2015-06-04
1497156228 Kelly Zalewski Social Worker 24631 Jefferson Ave, Saint Clair Shores, MI 48080 2014-09-11
1669871364 Mallory Margret Gordon Psychologist 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 2014-08-19
1932549375 Alexander Peter Bill Otolaryngology 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 2013-06-30
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Taxonomy Information

Taxonomy Code 207RA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Addiction Medicine

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548325186 Rudy J Vervaeke Md Plc Internal Medicine 24211 Little Mack Ave, Saint Clair Shores, MI 48080-1151 2006-12-26
1942300884 Southeastern Michigan Medical Consultants PC Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22
1558461426 Bharat Kumar Patel Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22
1083714976 Bharat Patel M.d. PC Internal Medicine 21420 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-3607 2006-09-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1013367473 East & West Physicians PC Internal Medicine 20905 Greenfield Rd Ste 608, Southfield, MI 48075-5355 2016-06-16
1033445861 Ayad M George, Pllc Internal Medicine 2132 Cedar St, Holt, MI 48842-1458 2009-10-29
1588821433 West Michigan Addiction Consultants, PC Internal Medicine 3001 Fuller Ave Ne, Suite 1, Grand Rapids, MI 49505-3247 2008-05-19
1730727850 Dearborn Pain Center Pllc Internal Medicine 624 E 9 Mile Rd, Hazel Park, MI 48030-1842 2019-12-19
1063069359 Faster Care Connor Creek, Pllc Internal Medicine 4777 E Outer Dr, Detroit, MI 48234-3241 2019-08-21
1356869572 America Recovery Center, Pllc Internal Medicine 20217 Ann Arbor Trl, Dearborn Heights, MI 48127-2692 2017-09-07
1356793954 Iha Health Services Corporation Internal Medicine 5333 Mcauley Dr Rm 5011, Ypsilanti, MI 48197-1003 2016-07-07
1770967226 Newhorizon Center LLC Internal Medicine 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1999 2015-07-15
1942618228 Changes Internal Medicine 19940 Conant St, Detroit, MI 48234-1494 2014-07-30
1033434253 Elizabeth Bulat Internal Medicine 37595 7 Mile Rd, # 240, Livonia, MI 48152-1003 2010-03-30
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Competitor

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City SAINT CLAIR SHORES
Zip Code 48080

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Dataset Information

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.

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