LEONID MIRONOVICH SHAMBAN (NPI# 1225398431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225398431 |
| Entity Type | Individual |
| Full Name | LEONID MIRONOVICH SHAMBAN |
| Credential | D.O. |
| Practice Address |
28963 Little Mack Ave Ste 101 Saint Clair Shores MI 48081 |
| Mailing Address |
28963 Little Mack Ave Ste 101 Saint Clair Shores MI 48081-3017 |
| Practice Telephone | 5864470700 |
| Practice Fax Number | 5864980707 |
| Mailing Telephone | 5864470228 |
| Mailing Fax Number | 5864980707 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2018-05-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
5101019763 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16001 W 9 Mile Rd, Southfield, MI 480754818 | 2488493000 |
| Street Address |
28963 LITTLE MACK AVE STE 101 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912103755 | Kerri Ann Bewick | Internal Medicine | 28963 Little Mack Ave Ste 101, Saint Clair Shores, MI 48081-3017 | 2007-06-26 |
| 1295915908 | Coka K Yip | Nurse Practitioner | 28963 Little Mack Ave Ste 101, Saint Clair Shores, MI 48081-3017 | 2007-11-09 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1912103755 | Kerri Ann Bewick | Internal Medicine | 28963 Little Mack Ave Ste 101, Saint Clair Shores, MI 48081-3017 | 2007-06-26 |
| 1154311405 | G I Medical Assoc PC | Internal Medicine | 28963 Little Mack Ave, Suite 101, Saint Clair Shores, MI 48081-3017 | 2005-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043785561 | Digestive Health Clinic | Internal Medicine | 2486 Nerredia St Ste A, Flint, MI 48532-4807 | 2018-10-11 |
| 1053808550 | Dr. Allison Wood, Do Mph, Pllc | Internal Medicine | 4136 Legacy Pkwy Ste 100, Lansing, MI 48911-4293 | 2018-04-19 |
| 1346698784 | Spectrum Health Primary Care Partners | Internal Medicine | 2009 Holton Road, Muskegon, MI 49445 | 2016-05-26 |
| 1043698988 | Krishna Chaitanya Meka | Internal Medicine | 27301 Dequindre Rd Ste 314, Madison Heights, MI 48071 | 2015-05-12 |
| 1609260892 | Chia-yang Hsu | Internal Medicine | A. Alfred Taubman Health Care Center, 1500 East Medical Center Drive Room 3912, Ann Arbor, MI 48109 | 2015-03-25 |
| 1982015228 | Access Family Gastroenterology Pllc | Internal Medicine | G-1125 Linden Rd, Suite 500, Flint, MI 48532 | 2014-05-08 |
| 1740610401 | Gastrofit Pllc | Internal Medicine | 23500 Park St Ste 2b, Dearborn, MI 48124-2598 | 2013-11-17 |
| 1578908000 | Emily E Tommolino | Internal Medicine | 26850 Providence Pkwy Ste 510, Novi, MI 48374-1267 | 2013-05-10 |
| 1679917074 | Harold Joseph Tobes | Internal Medicine | 1205 Nakomis Trl, Lake Orion, MI 48362-1340 | 2013-04-29 |
| 1245598606 | Ziad Kanaan | Internal Medicine | 215 E Mansion St Ste 3a, Marshall, MI 49068 | 2012-04-24 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on LEONID MIRONOVICH SHAMBAN.
| 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.