CHARLES J SHANLEY MD PC (NPI# 1942561428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942561428 |
| Entity Type | Organization |
| Organization Name | CHARLES J SHANLEY MD PC |
| Practice Address |
1001 Audubon Rd Grosse Pointe MI 48230-1406 |
| Practice Telephone | 3132687391 |
| Mailing Telephone | 3132687391 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |
| Authorized Official Name | CHARLES J SHANLEY (PHYSICIAN OWNER) |
| Authorized Official Telephone | 3132687391 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301051382 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
1001 AUDUBON RD |
| City | GROSSE POINTE |
| State | MI |
| Zip Code | 48230-1406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573450 | Burd Home Health LLC | In Home Supportive Care | 15001 Kerchezal Ave Unit #2042, Grosse Point Park, MI 48230 | 2020-09-16 |
| 1962924886 | Michelle Kathleen Harr | Speech-Language Pathologist | 1356 Bishop Rd, Grosse Pointe Park, MI 48230 | 2017-07-12 |
| 1356711766 | Jerry George Idicula | Behavioral Analyst | 1332 Maryland St, Grosse Pointe Park, MI 48230 | 2015-09-28 |
| 1578939930 | Sierra Gray | Contractor | 890 Cadieux, Grosse Pointe, MI 48230 | 2015-08-19 |
| 1023413853 | Cristovao Bartolo Carreira | Psychologist | 15450 E. Jefferson, Suite 200, Grosse Pointe, MI 48230 | 2014-10-22 |
| 1215217005 | Nui Loa PC | Community/Behavioral Health | 502 Pemberton, Grosse Pointe Park, MI 48230 | 2011-08-24 |
| 1295041846 | Greg Washington LLC | Psychiatry & Neurology | 793 Harcourt, Grosse Pointe Park, MI 48230 | 2010-08-20 |
| 1649445867 | Philip Charles Hessburg | Ophthalmology | 15415 E Jefferson Street, Grosse Pointe Park, MI 48230 | 2008-04-29 |
| 1437289071 | John Boyd Krisel Jr. | Social Worker | 15200 E Jefferson, Suite 105, Grosse Pointe Park, MI 48230 | 2007-03-06 |
| 1346382819 | Robert James Sisler | Social Worker | 15200 East Jefferson, Suite 105, Grosse Pointe Park, MI 48230 | 2007-02-13 |
| Find all providers in zip 48230 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689614141 | Charles J Shanley | Surgery | 16815 E Jefferson Ave Ste 240, Grosse Pointe, MI 48230-1923 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437660057 | Iha Health Services Corporation | Surgery | 5333 Mcauley Dr Rm 4016, Ypsilanti, MI 48197-1001 | 2017-10-23 |
| 1760900138 | Integrated Vascular Vein Center of Michigan PC | Surgery | 600 Health Park Blvd Ste G, Grand Blanc, MI 48439-2558 | 2017-09-06 |
| 1770036147 | Joseph P. Elliott Jr. | Surgery | 3282 Woodview Lake Rd, West Bloomfield, MI 48323-3570 | 2016-08-02 |
| 1043676661 | Integrative Cardiovascular Health & Wellness | Surgery | 3250 Woods Way, Suite 9, Petoskey, MI 49770-7628 | 2016-01-12 |
| 1124411244 | Vascular Surgery Assoc, PC | Surgery | 1122 S Lapeer Rd Ste C, Lapeer, MI 48446-3387 | 2015-03-13 |
| 1013309988 | Bloomfield Vein & Vascular Pllc | Surgery | 43700 Woodward Ave Ste 207, Bloomfield Hills, MI 48302-5061 | 2015-03-02 |
| 1114288206 | Scott Bendix | Surgery | 28100 Grand River Ave Ste 200, Farmington Hills, MI 48336-5969 | 2012-06-05 |
| 1508122995 | Robert J Cardwell Md Pllc | Surgery | 13312 Terry Dr, Shelby Township, MI 48315-5365 | 2012-04-10 |
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| 1437383197 | Barbara D'agnoluzzo Moreira | Surgery | 3663 Woodward Ave Ste 200, Wsu Detroit Medical Center, Detroit, MI 48201-2400 | 2009-05-11 |
| Find all providers with the same taxonomy | ||||
| City | GROSSE POINTE |
| Zip Code | 48230 |
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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.