DR. PETER L WICKENS (NPI# 1275637381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275637381 |
| Entity Type | Individual |
| Full Name | DR. PETER L WICKENS |
| Credential | D.O. |
| Practice Address |
14050 14 Mile Road Warren MI 48088 |
| Practice Telephone | 5862932088 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101006061 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | 0855026825 | 01 |
| Street Address |
14050 14 MILE ROAD |
| City | WARREN |
| State | MI |
| Zip Code | 48088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1023679099 | Jeff Lip | Counselor | 13253 Cromie Dr., Warren, MI 48088 | 2019-06-21 |
| 1306229877 | Medico Care LLC | Health Maintenance Organization | 31418 Schoenherr Rd #5, Warren, MI 48088 | 2015-07-02 |
| 1053728030 | Jane Kennedy Bays | Counselor | 30521 Schoenherr Rd Ste 200, Warren, MI 48088 | 2014-07-22 |
| 1114295490 | Ma Corazon E Marcaida-gorospe | Physical Therapist | 27472 Schoenherr Road, Warren, MI 48088 | 2011-12-01 |
| 1578869277 | Chiropractic Urgent Care, P.C. | Clinic/Center | 31500 Schoenherr Rd., Warren, MI 48088 | 2011-01-28 |
| 1396071361 | Colleen Janness | Physician Assistant | 13450 East 12 Mile Rd, Advanced Dermatology of Michigan, PC, Warren, MI 48088 | 2009-10-27 |
| 1225266075 | Pain Management Center | General Practice | 27472 Schoneherr, #130, Warren, MI 48088 | 2009-06-30 |
| 1447495809 | Denise Stys Marecki | Dietitian, Registered | 30061 Schoenherr Rd., Suite C, Warren, MI 48088 | 2008-12-12 |
| 1568640878 | James H. Aronovitz, Do Pllc | Otolaryngology | 27301 Schoenherr, 105, Warren, MI 48088 | 2008-02-08 |
| Find all providers in zip 48088 | ||||
| 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 |
|---|---|---|---|---|
| 1770111072 | Olive Branch Medical Associates Pllc | Family Medicine | 1270 County Road 4755, Warren, TX 77664-7714 | 2020-03-31 |
| 1689169542 | Warren Family Practice, Pllc | Family Medicine | 26000 Hoover Rd Ste 105, Warren, MI 48089-1167 | 2018-06-24 |
| 1992116396 | Bradley Newton Biggers | Family Medicine | 304 E Central St., Warren, AR 71671 | 2014-05-19 |
| 1174969927 | Vikas Sacher | Family Medicine | Warren General Hospital, 2 W Crescent Park, Warren, PA 16365-2111 | 2013-05-21 |
| 1609108679 | Douglas Luke Kehres | Family Medicine | 1997 Niles Cortland Rd Se, Warren, OH 44484-3037 | 2010-02-02 |
| 1891026019 | Gary William Stucke | Family Medicine | 511 Kenmore Ave., Ne, Warren, OH 44483-5521 | 2010-01-28 |
| 1790014835 | Jeffery Elwood Hess | Family Medicine | 30400 Mound Rd, Manufacturing Bldg. C, Warren, MI 48092-2029 | 2009-12-21 |
| 1295977007 | Frank A. Diponio Jr. D.o. P.C. | Family Medicine | 29250 Heritage Parkway, Warren, MI 48092 | 2009-03-26 |
| 1669617296 | Donald Nicholas Vandamia | Family Medicine | 64 Leda Lane, Warren, PA 16365 | 2008-12-11 |
| 1598941148 | Oleh Bolukh | Family Medicine | 2539 E 12 Mile Rd, Warren, MI 48092-5648 | 2008-01-14 |
| Find all providers in WARREN | ||||
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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.