Matthew Jerome Boutorwick (NPI# 1144631292, PAC ID# 0547569469) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
Nation Provider ID (NPI) | 1144631292 |
PAC ID by PECOS | 0547569469 |
Professional Enrollment ID | I20180430000107 |
Full Name | Matthew Jerome Boutorwick |
Organization Legal Name | OBSERVATION EMERGENCY PHYSICIANS PC |
Address |
11800 E 12 Mile Rd Warren MI 48093-3472 |
Phone Number | 5865735059 |
Gender | M |
Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
Graduation Year | 2014 |
Primary Specialty | EMERGENCY MEDICINE |
Group Practice PAC ID | 9133292410 |
Number of Group Practice Members | 34 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
230195 | ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER |
230241 | ST JOHN RIVER DISTRICT HOSPITAL |
230165 | ST JOHN HOSPITAL AND MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
11800 E 12 Mile Rd, Warren, MI 48093-3472 | 5865735059 | OBSERVATION EMERGENCY PHYSICIANS PC |
Organization Legal Name | OBSERVATION EMERGENCY PHYSICIANS PC |
Physicians | 49 |
Name | Specialty | Organization | Address |
---|---|---|---|
Micheal D Buggia | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Domian F Kandah | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Shawndelin M Wilson | Physician Assistant | Observation Emergency Physicians PC | 22101 Moross Rd, Detroit, MI 48236-2148 |
Margarita E Pena | Emergency Medicine | Observation Emergency Physicians PC | 22101 Moross Rd, Detroit, MI 48236-2148 |
David J Ahee | Emergency Medicine | Observation Emergency Physicians PC | 22101 Moross Rd, Detroit, MI 48236-2148 |
Jessica R Ruffino | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Daniel Stanley Gadzinski | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Ilya Kott | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Shaun B Gray | Emergency Medicine | Observation Emergency Physicians PC | 22101 Moross Rd, Detroit, MI 48236-2148 |
David R Hanscom | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Street Address |
11800 E 12 MILE RD |
City | WARREN |
State | MI |
Zip | 48093-3472 |
Name | Specialty | Organization | Address |
---|---|---|---|
Micheal D Buggia | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Domian F Kandah | Emergency Medicine | Observation Emergency Physicians PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Metodija Naumovski | Certified Registered Nurse Anesthetist (crna) | Ascension Macomb Oakland Hospital | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Umberto Berlasi | Anesthesiology | American Anesthesiology of Michigan PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Sindhu Koshy | Cardiovascular Disease (cardiology) | Ascension Macomb Oakland Hospital | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Ronald A Bonaventura | Nurse Practitioner | Ascension Macomb Oakland Hospital | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Matthew Michael Edwards | Physician Assistant | Diagnostic Radiology Consultants PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Norbert Kadler | Certified Registered Nurse Anesthetist (crna) | Ascension Macomb Oakland Hospital | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Diane M Pokorski | Certified Registered Nurse Anesthetist (crna) | Ascension Macomb Oakland Hospital | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Saifuddin T Vohra | Diagnostic Radiology | Diagnostic Radiology Consultants PC | 11800 E 12 Mile Rd, Warren, MI 48093-3472 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Daniel C Aronovitz | Podiatry | 31730 Hoover Rd B, Warren, MI 48093-1700 | |
Jane E Krasnick | Allergy/immunology | Warren Allergy and Asthma Care, PC | 31730 Hoover Rd A, Warren, MI 48093-1700 |
Carey C Linden | Allergy/immunology | Warren Allergy and Asthma Care, PC | 31730 Hoover Rd A, Warren, MI 48093-1700 |
Ogechi Nita Enyioko | Nurse Practitioner | Doctors Home Line Pllc | 30500 Van Dyke Ave, Suite 203, Warren, MI 48093-2109 |
Pauline Robinson | Nurse Practitioner | Doctors Home Line Pllc | 30500 Van Dyke Ave, Suite 203, Warren, MI 48093-2109 |
Barry C Smith | Physician Assistant | Doctors Home Line Pllc | 30500 Van Dyke Ave, Suite 203, Warren, MI 48093-2109 |
Shobha Subramanian | General Practice | American Home Doctors PC | 8200 E 13 Mile Rd, Suite 101, Warren, MI 48093-2171 |
Dean A Ruble | General Practice | American Home Doctors PC | 8200 E 13 Mile Rd, Suite 101, Warren, MI 48093-2171 |
Stephanie M Paluda | Obstetrics/gynecology | Mission Obstetrics and Gynecology P C | 11300 E 13 Mile Rd, Suite 4, Warren, MI 48093-2500 |
Kristen Wuckert | Obstetrics/gynecology | Mission Obstetrics and Gynecology P C | 11300 E 13 Mile Rd, Suite 4, Warren, MI 48093-2500 |
Find all physicians in zip 48093 |
City | WARREN |
Zip Code | 48093 |
Specialty | EMERGENCY MEDICINE |
City + Specialty | WARREN + EMERGENCY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.