DR. PETER CHARLES DODENHOFF (NPI# 1174544928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174544928 |
| Entity Type | Individual |
| Full Name | DR. PETER CHARLES DODENHOFF |
| Credential | DO, PC |
| Practice Address |
21811 Kelly Rd Suite 107 Eastpointe MI 48021 |
| Practice Telephone | 5867730200 |
| Practice Fax Number | 5867739803 |
| Mailing Telephone | 5867730200 |
| Mailing Fax Number | 5867739803 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2009-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101006192 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1075599110 | 05 | |
| MI | BCBS | 55033895 | 01 |
| Street Address |
21811 KELLY RD SUITE 107 |
| City | EASTPOINTE |
| State | MI |
| Zip Code | 48021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770754822 | Peter C. Dodenhoff Do PC | Family Medicine | 21811 Kelly Rd, Suite 107, Eastpointe, MI 48021-2793 | 2008-03-17 |
| 1013131226 | Robert Valice | Dentist | 21811 Kelly Rd, Suite 101, Eastpointe, MI 48021-2793 | 2007-04-12 |
| 1376605022 | Robert Paul Kingscott | Pharmacist | 21811 Kelly Rd, Suite 103, Eastpointe, MI 48021-2793 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588137483 | Beautiful Tomorrow Inc | Home Health | 22430 Gratiot Ave., Eastpointe, MI 48021 | 2019-01-03 |
| 1760922553 | Urgent Care Plus, PC | Clinic/Center | 16184 E 10 Mile Rd Ste 102, Eastpointe, MI 48021 | 2017-02-28 |
| 1295187961 | Danielle Wansley | Licensed Practical Nurse | 24934 Rawen Ave, Eastpointe, MI 48021 | 2016-07-06 |
| 1548615966 | Unique Burton | Licensed Practical Nurse | 15025 Charles, Eastpointe, MI 48021 | 2016-05-04 |
| 1376908707 | Dalinda Richardson | Physical Therapist | 18200 E Tenmile Road, 200, Eastpointe, MI 48021 | 2015-12-30 |
| 1780050369 | Russell Marcilis II | Prosthetic/Orthotic Supplier | 18121 E. 8 Mile Ste 100, Eastpointe, MI 48021 | 2015-08-18 |
| 1841603594 | Charlotte Loraine Kroll | Dentist | 24541 Gratiot Ave., Eastpointe, MI 48021 | 2014-06-10 |
| 1114357720 | Zuri Tanay Boyd-mcgarrity | Social Worker | 4160 Woodward, 2nd Floor, Detroit, MI 48021 | 2013-11-18 |
| 1619219888 | Bettye Ruth Edwards | Social Worker | 23721 Kelly # 7, Eas Pointe, MI 48021 | 2013-03-26 |
| 1578807392 | Angela Marie Travis | Specialist | 21062 Kelly Road, Eastpoint, MI 48021 | 2012-11-16 |
| Find all providers in zip 48021 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598922783 | Richard A Fici Do Pllc | Family Medicine | 18200 E 10 Mile Rd Ste 100, Eastpointe, MI 48021-1368 | 2008-05-16 |
| 1114046877 | Family Medical Center, Inc. | Family Medicine | 24420 Gratiot Ave, Eastpointe, MI 48021-3307 | 2007-03-27 |
| 1730292079 | Richard A Fici | Family Medicine | 18200 10 Mile Rd, Suite 100, Eastpointe, MI 48021 | 2006-08-17 |
| 1619934320 | Nwanneka U. Odumodu | Family Medicine | 16184 E 10 Mile Rd Ste 101, Eastpointe, MI 48021 | 2006-04-27 |
| 1558353458 | Annetta Margaret Byrne | Family Medicine | 22480 Kelly Rd, Suite A, Eastpointe, MI 48021-2623 | 2005-08-17 |
| 1376999573 | Heritage Medical Group P.C. | Family Medicine | 22301 Kelly Rd, Eastpointe, MI 48021-2619 | 2016-05-06 |
| 1740554666 | David Bryan Cox | Family Medicine | 22301 Kelly Rd, Eastpointe, MI 48021-2619 | 2012-02-24 |
| 1659698884 | Administrative Specialists, LLC | Family Medicine | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2010-04-28 |
| 1912224148 | Primary Care Physicians Iv, P.C. | Family Medicine | 21331 Kelly Rd, Eastpointe, MI 48021-3265 | 2010-04-28 |
| 1770754822 | Peter C. Dodenhoff Do PC | Family Medicine | 21811 Kelly Rd, Suite 107, Eastpointe, MI 48021-2793 | 2008-03-17 |
| Find all providers in EASTPOINTE | ||||
| City | EASTPOINTE |
| Zip Code | 48021 |
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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.