DR. KENNETH R CERVONE (NPI# 1316937873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316937873 |
| Entity Type | Individual |
| Full Name | DR. KENNETH R CERVONE |
| Credential | MD |
| Practice Address |
24715 Little Mack Ste 100 St Clair Shore MI 48080 |
| Mailing Address |
24715 Little Mack Ave Suite 100 Saint Clair Shores MI 48080-3207 |
| Practice Telephone | 5867797970 |
| Practice Fax Number | 5867797748 |
| Mailing Telephone | 5867797970 |
| Mailing Fax Number | 5867797748 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2014-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 4301058405 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3250375 | 05 |
| Street Address |
24715 LITTLE MACK STE 100 |
| City | ST CLAIR SHORE |
| State | MI |
| Zip Code | 48080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805365 | Conner D Ahlgren | Orthopaedic Surgery | 3535 W 13 Mile Rd Ste 742, Royal Oak, MI 48073-6770 | 2020-06-09 |
| 1063035319 | Alex Kane Miller | Orthopaedic Surgery | 3577 W 13 Mile Rd Ste 402, Royal Oak, MI 48073-6710 | 2020-05-21 |
| 1396374716 | Arjun Patel | Orthopaedic Surgery | Ascension Genesys, Gme Dept, One Genesys Pkwy, Grand Blanc, MI 48439-4843 | 2020-04-07 |
| 1346876711 | Timothy Curtis Mead | Orthopaedic Surgery | 4752 Lake Harbor Rd, Norton Shores, MI 49441-5236 | 2020-03-18 |
| 1932751112 | Mendelson Warren Pharmacy | Orthopaedic Surgery | 11900 E 12 Mile Rd Ste 105, Warren, MI 48093-3487 | 2019-07-09 |
| 1023678059 | Th Mg Ohio LLC | Orthopaedic Surgery | 1050 Wilshire Dr Ste 300, Troy, MI 48084-1526 | 2019-06-20 |
| 1609430321 | Mohamed Saad-waterworks, PC | Orthopaedic Surgery | 21031 Michigan Ave Fl 2, Dearborn, MI 48124-2339 | 2019-04-29 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| 1588228845 | Muhammad Talha Padela | Orthopaedic Surgery | 3990 John R St Ste 7b, Detroit, MI 48201 | 2019-04-23 |
| 1134681125 | Neuro Spine Institute Pllc | Orthopaedic Surgery | 29255 Northwestern Hwy Ste 202, Southfield, MI 48034-5741 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | ST CLAIR SHORE |
| Zip Code | 48080 |
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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.