DR. BRADLEY GONIK (NPI# 1952862765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952862765 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY GONIK |
| Credential | MD |
| Practice Address |
24911 Little Mack Ave Ste C Saint Clair Shores MI 48080-3200 |
| Practice Telephone | 5867772050 |
| Practice Fax Number | 5867772189 |
| Mailing Telephone | 5867772050 |
| Mailing Fax Number | 5867772189 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
24911 LITTLE MACK AVE STE C |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275525966 | Sigmund O Mcintyre | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2005-08-18 |
| 1245851039 | William Henry Bachman | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2020-05-03 |
| 1467072017 | Michelle Tavera | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2020-04-23 |
| 1619539418 | Julia Joanna Knobelsdorf | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-07-01 |
| 1427610518 | Nicole Ognjanovski | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-06-28 |
| 1033770078 | Emianka Sotiri | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-06-20 |
| 1194286484 | Camille Brazzle | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-03-28 |
| 1952862336 | Ana Ifti | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-03-27 |
| 1629561907 | Kathryn Elyse Cox | Family Medicine | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-06-11 |
| 1396238184 | Delair Lucas Alnajjar | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-06-07 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659720225 | Yiqing Xu | Student in an Organized Health Care Education/Training Program | 21715 Alger St, Saint Clair Shores, MI 48080-1872 | 2016-06-06 |
| 1245851039 | William Henry Bachman | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2020-05-03 |
| 1427610518 | Nicole Ognjanovski | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-06-28 |
| 1194286484 | Camille Brazzle | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-03-28 |
| 1952862336 | Ana Ifti | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2019-03-27 |
| 1396238184 | Delair Lucas Alnajjar | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-06-07 |
| 1336631282 | Valerie Ann Efros | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-06-05 |
| 1487143889 | Leah Sara Vandenbussche | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-05-02 |
| 1487141016 | Marcus Dwayne Allen | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2018-04-19 |
| 1548790561 | Vakar Khan | Student in an Organized Health Care Education/Training Program | 24911 Little Mack Ave Ste C, Saint Clair Shores, MI 48080-3200 | 2017-06-13 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
Please comment or provide details below to improve the information on DR. BRADLEY GONIK.
| 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.