LAKESHORE EAR NOSE AND THROAT CENTER PC (NPI# 1033202023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033202023 |
Entity Type | Organization |
Organization Name | LAKESHORE EAR NOSE AND THROAT CENTER PC |
Practice Address |
21000 E 12 Mile Rd Suite 111 Saint Clair Shores MI 48081-1116 |
Practice Telephone | 5867797610 |
Mailing Telephone | 5867797610 |
Enumeration Date | 2006-10-02 |
Last Update Date | 2007-10-12 |
Authorized Official Name | DR. DANIEL DJ MEGLER (PRESIDENT CHIEF EXECUTIVE OFFICE) |
Authorized Official Telephone | 5867797610 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BLUE SHIELD | 0E01107 | 01 | |
BLUE SHIELD GROUP | 0E06192 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285803346 | Lakeshore Ear Nose and Throat Center PC | Otolaryngology | 11080 Hall Rd, A, Sterling Heights, MI 48314-1511 | 2008-02-22 |
1194921692 | Lakeshore Ear Nose and Throat Center PC | Internal Medicine | 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 | 2007-06-22 |
Street Address |
21000 E 12 MILE RD SUITE 111 |
City | SAINT CLAIR SHORES |
State | MI |
Zip Code | 48081-1116 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255330486 | Jennifer Kay Appleyard | Allergy & Immunology | 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 | 2005-07-19 |
1881203479 | Andrew Michael Keltz | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2020-07-29 |
1770120230 | Holly Ann Reckers | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-12-04 |
1578037966 | Maria Juliana Codino | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-01-18 |
1942779921 | Maria D Samsa | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2018-11-19 |
1801331210 | Katja N Tandarich | Nurse Practitioner | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2016-12-21 |
1053854133 | Jean P. Skeffington | Speech-Language Pathologist | 21000 E 12 Mile Rd, Suite111, Saint Clair Shores, MI 48081-1116 | 2016-11-22 |
1134588254 | Alyssa Domenica Baker | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2016-02-17 |
1316350192 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2014-06-09 |
1720404775 | Sean Anthony Cassleman | Internal Medicine | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2014-03-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
Find all providers in zip 48081 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669868402 | Cameron M Heilbronn | Otolaryngology | 21000 E 12 Mile Rd Ste 111, Saint Clair Shores, MI 48081-1156 | 2015-04-08 |
1568554087 | Adam D Rubin | Otolaryngology | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2006-09-29 |
1881786341 | Robert A Fishman | Otolaryngology | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2006-09-29 |
1922190552 | Daniel Dj Megler | Otolaryngology | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2006-09-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104445980 | Anuja Dharap | Otolaryngology | 35630 Grand River Ave Apt 217, Farmington Hills, MI 48335-3120 | 2020-04-13 |
1598311334 | Cogent Medical Group Pllc | Otolaryngology | 28300 Orchard Lake Rd Ste 101, Farmington Hills, MI 48334-3704 | 2019-08-16 |
1073025334 | Robert J Stachler Md PC | Otolaryngology | 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 | 2017-10-26 |
1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
1174905822 | Scott Jacob Schwartz | Otolaryngology | 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 | 2015-06-18 |
1104230523 | Gary Zachary White | Otolaryngology | 300 North Ave Ste 1400, Battle Creek, MI 49017 | 2014-06-13 |
1437574530 | Beacon Medical Group, Inc. | Otolaryngology | 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 | 2014-02-26 |
1124361621 | Eric Fahed Succar | Otolaryngology | 44200 Woodward Ave Ste 201, Pontiac, MI 48341-5045 | 2013-04-03 |
1396086286 | Nathan Vandjelovic | Otolaryngology | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2013-03-03 |
1497091078 | Henry L Singer | Otolaryngology | 2341 Tor Ln, Petoskey, MI 49770-9768 | 2012-12-30 |
Find all providers with the same taxonomy |
City | SAINT CLAIR SHORES |
Zip Code | 48081 |
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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.