JONATHAN WAXMAN (NPI# 1386063824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386063824 |
| Entity Type | Individual |
| Full Name | JONATHAN WAXMAN |
| Practice Address |
4201 Saint Antoine St Uhc 5-e Detroit MI 48201-2153 |
| Practice Telephone | 3135770804 |
| Mailing Telephone | 3135770804 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2019-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 4301105881 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194761973 | Jonathan Waxman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 | 2006-06-21 |
| Street Address |
4201 SAINT ANTOINE ST UHC 5-E |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760477871 | John Mckay Perkowski | Nurse Anesthetist, Certified Registered | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2005-09-14 |
| 1013517028 | Madappulli Arachchige Wickrama | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-10-28 |
| 1134731466 | Helda Bacall | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-08-18 |
| 1568088680 | Michelle De Varennes | Physician Assistant | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-24 |
| 1235754144 | Saren Yeranosian | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-16 |
| 1083239230 | Jacqueline Ferraro-jaworski | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-13 |
| 1770107617 | Zamaan Sayeed Sohel | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-06 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1487276721 | Andrew R Kumar | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-09 |
| 1598386005 | Kayla Richelle Robinson | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-06 |
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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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| 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 Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396086286 | Nathan Vandjelovic | Otolaryngology | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2013-03-03 |
| 1013223239 | Samba Siva Reddy Bathula | Otolaryngology | 4160 John R St Ste 1007, Dmc Ent-harper Professional Building, Detroit, MI 48201-2017 | 2010-08-25 |
| 1801109277 | Syed Naweed Raza | Otolaryngology | 4100 John R Wertz Clinic, Karmanos Cancer Center, Detroit, MI 48201-2013 | 2010-07-14 |
| 1396783460 | George H Yoo | Otolaryngology | 4100 John R Wertz Clinc, Detroit, MI 48201-2013 | 2006-06-02 |
| 1225088339 | Salvatore Cavaliere | Otolaryngology | 6071 W Outer Drive 7/east, Select Speciality Hospital, Detroit, MI 48235-2624 | 2006-05-11 |
| 1215463823 | Samantha Tam | Otolaryngology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2017-05-03 |
| 1730621723 | Michigan Sinus and Skull Institute Pllc | Otolaryngology | 4100 John R St, Wertz Cancer Clinic, Detroit, MI 48201-2013 | 2016-11-08 |
| 1750778890 | Catherine Mae Kelso Geller | Otolaryngology | 4201 Saint Antoine St, 5e-uhc, Detroit, MI 48201-2153 | 2015-04-15 |
| 1679968390 | Zaahir Turfe | Otolaryngology | 2799 W Grand Blvd, Henry Ford Hospital Graduate Medical Education, Cfp-046, Detroit, MI 48202-2608 | 2015-03-31 |
| 1386033272 | Madana Jeevanandam | Otolaryngology | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2015-01-14 |
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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.