SIRAJ PANCHBHAIYA (NPI# 1962841544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962841544 |
| Entity Type | Individual |
| Full Name | SIRAJ PANCHBHAIYA |
| Credential | D.P.M. |
| Practice Address |
11900 E 12 Mile Rd Ste 102 Warren MI 48093-3487 |
| Mailing Address |
20176 Livernois Ave 100 Detroit MI 48221-1346 |
| Practice Telephone | 5865737470 |
| Practice Fax Number | 5865730850 |
| Mailing Telephone | 3138647385 |
| Mailing Fax Number | 3138647384 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2015-08-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5901002488 | MI | Podiatric Medicine & Surgery Service Providers |
| Street Address |
11900 E 12 MILE RD STE 102 |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003436486 | Tariq Elagamy | Student in an Organized Health Care Education/Training Program | 11900 E 12 Mile Rd Ste 102, Warren, MI 48093-3487 | 2020-04-25 |
| 1912527391 | Rafi Jarjous | Student in an Organized Health Care Education/Training Program | 11900 E 12 Mile Rd Ste 102, Warren, MI 48093-3487 | 2020-04-25 |
| 1821618208 | Anna Grace Mauro | Student in an Organized Health Care Education/Training Program | 11900 E 12 Mile Rd Ste 102, Warren, MI 48093-3487 | 2020-04-25 |
| 1598151128 | Wissam Dimachk | Podiatrist | 11900 E 12 Mile Rd Ste 102, Warren, MI 48093 | 2015-04-10 |
| 1750794988 | Ross Christopher Bartley | Podiatrist | 11900 E 12 Mile Rd Ste 102, Warren, MI 48093-3487 | 2014-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134501885 | Jamie L Matteo Dpm, Inc | Podiatrist | 628 Niles Cortland Road Se Suite 103, Warren, OH 44484-2473 | 2015-06-18 |
| 1194061002 | Advanced Podiatry Ankle & Footcare Centers Inc | Podiatrist | 4441 Mahoning Ave Nw Ste A, Warren, OH 44483-1976 | 2012-12-20 |
| 1336389519 | Cara Christine Dunbar Kalogerou | Podiatrist | 628 Niles Cortland Rd Se Ste 103, Warren, OH 44484-2473 | 2009-02-27 |
| 1588804132 | Kenneth James Donovan | Podiatrist | 9 Mount Bethel Rd, Suite 9, Warren, NJ 07059-5603 | 2009-02-23 |
| 1437124492 | A Caring Podiatrist Inc | Podiatrist | 2900 Elm Road Ne, Warren, OH 44483 | 2006-02-22 |
| 1194703157 | Diana G Karnavas | Podiatrist | 4441 Mahoning Ave Nw, Suite A, Warren, OH 44483-1932 | 2006-01-09 |
| 1982606414 | Charles Gregory Kissel | Podiatrist | 29433 Ryan Rd, Warren, MI 48092-2203 | 2005-08-15 |
| 1073008371 | Firras Garada | Podiatrist | 21230 Dequindre Rd, Warren, MI 48091-2279 | 2018-06-28 |
| 1326531377 | Giulia Consulting Pllc | Podiatrist | 4050 E 12 Mile Rd, Warren, MI 48092-2534 | 2018-06-13 |
| 1477074904 | Seyed Sadegh Arab | Podiatrist | 21230 Dequindre Rd, Warren, MI 48091-2279 | 2017-07-06 |
| Find all providers in WARREN | ||||
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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.