DR. EDWIN ROBERT ITENBERG (NPI# 1255508487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255508487 |
| Entity Type | Individual |
| Full Name | DR. EDWIN ROBERT ITENBERG |
| Credential | D.O. |
| Practice Address |
16001 W 9 Mile Rd Fisher Building 3rd Floor Southfield MI 48075-4818 |
| Practice Telephone | 2488496030 |
| Practice Fax Number | 2488496039 |
| Mailing Telephone | 2488496030 |
| Mailing Fax Number | 2488496039 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2012-12-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 5101019112 | MI | Allopathic & Osteopathic Physicians |
| Y | 208C00000X | Colon & Rectal Surgery | 5101019112 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
16001 W 9 MILE RD FISHER BUILDING 3RD FLOOR |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929338 | Sally Rae Arbuckle | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2005-06-01 |
| 1730780651 | Jennifer Bekes | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-11-06 |
| 1497361133 | Matthew Hoffman | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-18 |
| 1447866215 | Marisa Mcalister | Nurse Practitioner | 16001 W 9 Mile Rd, Southfield, MI 48075-4803 | 2020-09-17 |
| 1629682935 | John Michael Faraj | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-03 |
| 1861017337 | Adnan Basheer | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-10 |
| 1891319885 | Seti Kelemework Belay | Radiology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-04 |
| 1467076851 | Alexa Rae Arvidson | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1275157638 | Angela Niezgoda | Obstetrics & Gynecology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1942824453 | Marc Thomas Zughaib | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114140167 | Ralph D Pearlman Md PC | Colon & Rectal Surgery | 22250 Providence Dr Ste 702, Southfield, MI 48075-6215 | 2007-04-10 |
| 1588121586 | Deepa Taggarshe Md Pllc | Colon & Rectal Surgery | 22250 Providence Dr Ste 702, Southfield, MI 48075-6215 | 2019-02-26 |
| 1467758292 | Aad, Pllc | Colon & Rectal Surgery | 22250 Providence Dr, #702, Southfield, MI 48075-4825 | 2011-01-26 |
| 1487853339 | Amir A. Damadi | Colon & Rectal Surgery | 22250 Providence Dr., #702, Southfield, MI 48075 | 2007-07-12 |
| 1033125992 | Ralph Donald Pearlman | Colon & Rectal Surgery | 22250 Providence Dr, Ste #702, Southfield, MI 48075 | 2006-07-31 |
| 1093749095 | Michigan Colon & Rectal Surgeons, PC | Colon & Rectal Surgery | 18161 W 13 Mile Rd, Suite A1, Southfield, MI 48076-1113 | 2006-07-10 |
| 1801839899 | Ernesto R Drelichman | Colon & Rectal Surgery | 16001 W 9 Mile Rd, 3rd Floor Fisher, Southfield, MI 48075-4818 | 2006-06-14 |
| 1003814955 | Alasdair I.l. Mckendrick | Colon & Rectal Surgery | 22250 Providence Dr, Suite 208, Southfield, MI 48075-4825 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649566068 | Kristin M Busch | Colon & Rectal Surgery | 4201 Campus Ridge Dr, Midland, MI 48640-6128 | 2011-06-23 |
| 1215245329 | Warren P Mazier | Colon & Rectal Surgery | 7701 Conservation St Ne, Ada, MI 49301-9522 | 2010-09-23 |
| 1346566908 | William Lionel Beauregard | Colon & Rectal Surgery | 4406 Birch Run Dr, Troy, MI 48098-4341 | 2010-04-07 |
| 1770637753 | Chairat Chomchai | Colon & Rectal Surgery | 28111 Hoover Road, Suite 6a, Warren, MI 48093 | 2007-01-23 |
| 1225191844 | John C. Eggenberger | Colon & Rectal Surgery | 5325 Elliott Dr Ste 104, Ypsilanti, MI 48197-8633 | 2006-12-18 |
| 1518051358 | Colon and Rectal Surgery Associates PC | Colon & Rectal Surgery | 1126 Gull Rd, Kalamazoo, MI 49048 | 2006-10-03 |
| 1568569655 | Farouk S Tootla | Colon & Rectal Surgery | 44060 Woodward Ave, Bloomfield Hills, MI 48302-5038 | 2006-09-20 |
| 1962470435 | Harold D Friedl | Colon & Rectal Surgery | 1126 Gull Road, Colon and Rectal Surgery Associates PC, Kalamazoo, MI 49048-1726 | 2006-03-10 |
| 1619950631 | Ganesh R Deshmukh | Colon & Rectal Surgery | 3106 S Wayne Rd, Wayne, MI 48184 | 2005-11-23 |
| 1629050828 | Hans J Stein | Colon & Rectal Surgery | 1121 Crooks Rd, Royal Oak, MI 48067 | 2005-11-15 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.