ST CLAIR SPECIALTY PHYSICIANS PC (NPI# 1154361616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154361616 |
| Entity Type | Organization |
| Organization Name | ST CLAIR SPECIALTY PHYSICIANS PC |
| Other Organization Name | ST. CLAIR NEPHROLOGY, IDAHO NEPHROLOGY ASSOCIATES |
| Practice Address |
18001 E 10 Mile Rd Suite 1 Roseville MI 48066-3803 |
| Mailing Address |
45640 Schoenherr Rd Shelby Township MI 48315-6033 |
| Practice Telephone | 5862185800 |
| Practice Fax Number | 5865326496 |
| Mailing Telephone | 5862474300 |
| Mailing Fax Number | 5865326496 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | DR. JUKAKU TAYEB (PRESIDENT) |
| Authorized Official Telephone | 5862185800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Clair Nephrology, Idaho Nephrology Associates | Doing Business As Name - Organization |
| Street Address |
18001 E 10 MILE RD SUITE 1 |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912909540 | Jukaku Tayeb | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| 1437413168 | Mirjana Dimitrijevic | Internal Medicine | 18001 E 10 Mile Rd, Roseville, MI 48066 | 2012-06-27 |
| 1417105420 | Muddasser Saiyed-javed | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066 | 2008-09-03 |
| 1144484924 | Heather Lynn Henderson | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2008-07-11 |
| 1972505519 | Joel M Topf | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| 1295737831 | Quresh Khairullah | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| 1467454009 | Keith Bellovich | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| 1700888328 | Mohamed El-ghoroury | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750647285 | Piper Julie Hughes | Internal Medicine | 151 N Sunrise Ave Ste 1205, Roseville, CA 95661-2932 | 2012-04-10 |
| 1104948280 | Ameer Abdulrazzak | Internal Medicine | 18001 E 10 Mile, Suite 1, Roseville, MI 48066-3803 | 2007-04-06 |
| 1881647584 | Abdul R Effendi | Internal Medicine | 25710 Kelly Rd Ste 1, Roseville, MI 48066-4959 | 2006-05-17 |
| 1912909540 | Jukaku Tayeb | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2005-08-12 |
| 1326272501 | Neetu Sharma | Internal Medicine | 25710 Kelly Rd Ste 1, Roseville, MI 48066-4959 | 2009-05-04 |
| 1619101805 | Don N Chang | Internal Medicine | 151 N Sunrise Ave, Suite 1205, Roseville, CA 95661-2924 | 2009-05-04 |
| 1124265822 | Sourabh Kharait | Internal Medicine | 151 N Sunrise Ave, Suite 1205, Roseville, CA 95661-2924 | 2009-01-16 |
| 1467616433 | Marrouf Azar | Internal Medicine | 25710 Kelly Rd Ste 1, Roseville, MI 48066-4959 | 2008-07-17 |
| 1144484924 | Heather Lynn Henderson | Internal Medicine | 18001 E 10 Mile Rd, Suite 1, Roseville, MI 48066-3803 | 2008-07-11 |
| 1932396496 | Kidney Consultants of Michigan PC | Internal Medicine | 25710 Kelly Rd Ste 1, Roseville, MI 48066 | 2007-09-28 |
| Find all providers in ROSEVILLE | ||||
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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.