NATHAN GONIK (NPI# 1174759815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174759815 |
| Entity Type | Individual |
| Full Name | NATHAN GONIK |
| Credential | M.D. |
| Practice Address |
3901 Beaubien St Suite 2102 Detroit MI 48201-2119 |
| Practice Telephone | 3139666443 |
| Practice Fax Number | 3137450747 |
| Mailing Telephone | 3139666443 |
| Mailing Fax Number | 3137450747 |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2016-09-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
4301105847 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
3901 BEAUBIEN ST SUITE 2102 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528357506 | Mallory Brooke O'niel | Otolaryngology | 3901 Beaubien St Ste 2102, Detroit, MI 48201-2119 | 2011-03-30 |
| 1528258787 | Cecilia Canto Helwig | Otolaryngology | 3901 Beaubien St Ste 3515, Detroit, MI 48201 | 2007-07-25 |
| 1770831497 | Randa Al Barazi | Otolaryngology | 3901 Beaubien St, Children's Hospital of Michigan, Detroit, MI 48201 | 2012-08-28 |
| 1538399621 | Sonal Saraiya | Otolaryngology | 3901 Beaubien St, Detroit, MI 48201-2119 | 2009-07-23 |
| 1306047717 | Janardhan Rao Jagini | Otolaryngology | 3901 Beaubien St, Children's Hospital, 3rd Floor, Detroit, MI 48201-2119 | 2007-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568861557 | Henry Ford Wyandotte Hospital | Otolaryngology | 23050 West Rd Ste 240, Brownstown Twp, MI 48183-1473 | 2014-08-15 |
| 1538568696 | James Coticchia, M.d., P.C. | Otolaryngology | 18181 Oakwood Blvd Ste 202, Dearborn, MI 48124-4082 | 2014-08-14 |
| 1629300165 | Sinan Atmaca | Otolaryngology | 29120 Franklin Rd, Southfield, MI 48034-1105 | 2010-02-09 |
| 1437387297 | Ranga Reddy Sirigiri | Otolaryngology | 660 Trombley Dr, Troy, MI 48083-5135 | 2009-06-30 |
| 1134378730 | Ear, Nose & Throat Institute of Michigan, Pllc | Otolaryngology | 14555 Levan Rd, Suite 206, Livonia, MI 48154-5083 | 2008-09-18 |
| 1053589960 | Paragon Health PC | Otolaryngology | 501 S Drake Rd, Kalamazoo, MI 49009-3234 | 2008-02-13 |
| 1679631360 | Michigan Pediatric Ent Associates, Pllc | Otolaryngology | 7001 Orchard Lake Rd, Suite 320c, West Bloomfield, MI 48322-3604 | 2006-12-05 |
| 1083633911 | Mark Uzansky | Otolaryngology | 14555 Levan Rd, Suite 206, Livonia, MI 48154-5083 | 2006-07-19 |
| 1487645503 | David N Madgy | Otolaryngology | 7001 Orchard Lake Rd, Suite 320c, West Bloomfield, MI 48322-3604 | 2005-10-31 |
| 1124018213 | Michael S Haupert | Otolaryngology | 7001 Orchard Lake Rd, Suite 320c, West Bloomfield, MI 48322-3604 | 2005-10-28 |
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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.