NORTHEAST SURGICAL SPECIALISTS, PC (NPI# 1952576431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952576431 |
| Entity Type | Organization |
| Organization Name | NORTHEAST SURGICAL SPECIALISTS, PC |
| Practice Address |
43211 Dalcoma Dr Suite 4 Clinton Twp MI 48038-6309 |
| Mailing Address |
43211 Dalcoma Dr Suit 4 Clinton Twp MI 48038-6309 |
| Practice Telephone | 5862868800 |
| Practice Fax Number | 5862868068 |
| Mailing Telephone | 5862868800 |
| Mailing Fax Number | 5862868068 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2013-03-21 |
| Authorized Official Name | DR. PETER DAVID KOWYNIA (OWNER) |
| Authorized Official Telephone | 5862120606 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 4301051240 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 102873117 | 05 | |
| MI | BLUE CROSS BLUE SHIELD OF MICHIGAN | 02 0502600 | 01 |
| Street Address |
43211 DALCOMA DR SUITE 4 |
| City | CLINTON TWP |
| State | MI |
| Zip Code | 48038-6309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508474529 | Eagle Global Services LLC | Clinic/Center | 43211 Dalcoma Dr, Clinton Twp, MI 48038-6309 | 2020-07-15 |
| 1669790275 | Solution-based Counseling Services, LLC | Social Worker | 43211 Dalcoma Dr, Suite 7, Clinton Twp, MI 48038-6309 | 2010-05-06 |
| 1285718759 | Shishir Senapati Md PC | General Practice | 43211 Dalcoma Dr, #3, Clinton Twp, MI 48038-6309 | 2006-10-24 |
| 1952302861 | Prameela Devi Baddigam | Psychiatry & Neurology | 43211 Dalcoma Dr, Ste. 3, Clinton Twp, MI 48038-6309 | 2005-08-02 |
| 1386645299 | Basivi Reddy Baddigam | Psychiatry & Neurology | 43211 Dalcoma Dr, Ste. 3, Clinton Twp, MI 48038-6309 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1245343250 | Shivanhalli Prakash | Surgery | 43311 Commons Dr, Clinton Twp, MI 48038-1109 | 2006-08-16 |
| 1851301352 | Peter D Kowynia | Surgery | 43211 Dalcoma, Ste 7, Clinton Twp, MI 48038 | 2006-08-08 |
| 1679572465 | Gregory Scott Gaborek | Surgery | 38770 Garfield Rd, Clinton Twp, MI 48038-6620 | 2005-07-14 |
| 1467450304 | James Edward Johnson | Surgery | 37400 Garfield Rd, Suite 120, Clinton Twp, MI 48036-3648 | 2005-07-13 |
| 1649456211 | Thomas Fohnatee King | Surgery | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2008-01-14 |
| 1215122437 | Surgical Specialty Group LLC | Surgery | 16151 19 Mile Rd, Suite #301, Clinton Twp, MI 48038-1158 | 2007-09-11 |
| 1457409971 | Shivana N. Prakash Mdpc | Surgery | 43311 Commons Dr, Clinton Twp, MI 48038-1109 | 2007-01-08 |
| 1295816932 | Macomb Surgical Associates,p.c. | Surgery | 37400 Garfield Rd, Suite 120, Clinton Twp, MI 48036-3648 | 2006-10-18 |
| 1629057054 | James Joseph Giliberto Jr. | Surgery | 37400 Garfield Rd, Suite 120, Clinton Twp, MI 48036-3648 | 2006-01-13 |
| 1689672529 | Lynn Louise Mathia | Surgery | 37399 Garfield Rd, Suite 204, Clinton Twp, MI 48036-3672 | 2005-07-13 |
| Find all providers in CLINTON TWP | ||||
| City | CLINTON TWP |
| Zip Code | 48038 |
Please comment or provide details below to improve the information on NORTHEAST SURGICAL SPECIALISTS, PC.
| 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.