DR. NICHOLAS E TISDALE (NPI# 1962023754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962023754 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS E TISDALE |
| Credential | MD |
| Practice Address |
3031 W Grand Blvd Ste 600 Detroit MI 48202-3014 |
| Mailing Address |
6510 Legacy Woods Trl West Bloomfield MI 48322-4804 |
| Practice Telephone | 2484695646 |
| Mailing Telephone | 2484695646 |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2020-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | MI | Student, Health Care |
| Street Address |
3031 W GRAND BLVD STE 600 |
| City | DETROIT |
| State | MI |
| Zip Code | 48202-3014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851831713 | Jennifer L Rostamabadi-cook | Psychiatry & Neurology | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2017-02-26 |
| 1467075515 | Tony Singh | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-24 |
| 1437772696 | Amanda Sandles | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-22 |
| 1760005177 | Mary Hao Hao | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-20 |
| 1619590262 | Daniel Mardit | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-18 |
| 1194347716 | Alex Vandenende | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-18 |
| 1518589894 | Laith Khalil | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-10 |
| 1225650567 | Hania Ghazi | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-09 |
| 1487275087 | Kabir Vohra | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-05 |
| 1194346726 | Nathaline Chiu | Student in an Organized Health Care Education/Training Program | 3031 W Grand Blvd Ste 600, Detroit, MI 48202-3014 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| 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 |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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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.