MARY FITZGERALD (NPI# 1386133478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386133478 |
| Entity Type | Individual |
| Full Name | MARY FITZGERALD |
| Credential | MD |
| Practice Address |
22101 Moross Rd Detroit MI 48236 |
| Mailing Address |
22101 Moross Rd Detroit MI 48236-2148 |
| Practice Telephone | 3133433400 |
| Practice Fax Number | 3133434056 |
| Mailing Telephone | 3133433400 |
| Mailing Fax Number | 3133434056 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2019-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 4351039064 | MI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 4301114701 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301114701 | MI | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326427030 | Mary Fitzgerald | Counselor | 39 S Villa Ave, Villa Park, IL 60181-2650 | 2015-05-27 |
| 1124395306 | Mary Doris Fitzgerald | Counselor | 2130 Lawson Creek Rd, Douglas, AK 99824-5010 | 2011-11-16 |
| 1457537391 | Mary Denise Fitzgerald | Massage Therapist | 245 S Highland St, Suite 6, Mount Dora, FL 32757-5781 | 2008-01-10 |
| 1902000474 | Mary Fitzgerald | Social Worker | 5480 Wisconsin Ave Ste 225, Chevy Chase, MD 20815-3503 | 2007-06-11 |
| 1306963152 | Mary Brito Fitzgerald | Counselor | 316 Metacom Ave, Bristol, RI 02809-5105 | 2007-03-26 |
| 1114001971 | Mary W Fitzgerald | Social Worker | 5540 Tech Center Dr, Springs Counseling Center, #203, Colorado Springs, CO 80919-2331 | 2006-10-25 |
| 1013021757 | Mary Anne Fitzgerald | Nurse Practitioner | 815 N Broadway Ave, Tyler, TX 75702-4507 | 2006-08-19 |
| 1245207083 | Mary P Fitzgerald | Obstetrics & Gynecology | 5500 S 5th Avenue, Bldg 1, Room 320, Hines, IL 60141 | 2006-03-01 |
| 1215908058 | Mary Trabue Fitzgerald | Audiologist | 3704 Sycamore Ln, Nashville, TN 37215-1914 | 2006-01-30 |
| 1093193179 | Mary Fitzgerald | Residential Treatment Facility, Physical Disabilities | 4650 S Panther Creek Dr, The Woodlands, TX 77381-2764 | 2015-05-11 |
| Street Address |
22101 MOROSS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609887 | Anne M Schneider | Obstetrics & Gynecology | 22101 Moross Rd, 313, Detroit, MI 48236-2148 | 2005-09-19 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1588261556 | Ryan Guthrie | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-02 |
| 1578160743 | Lauren Kudirka | Speech-Language Pathologist | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-01 |
| 1952918740 | Lisa Colombo | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1124635917 | Gjergj George Juncaj | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1194337881 | Lori Holaly | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-23 |
| 1548870066 | Tamara Siblini | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-10 |
| 1104436583 | David Mark Thomas | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-31 |
| 1780293969 | Alexander Swend Mortensen | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1851852263 | Samantha Allegra Chamberlain | Emergency Medicine | 22101 Moross Rd., Emergency Department, Detroit, MI 48236-2148 | 2019-03-28 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1417417536 | Joseph Julius Vermeulen | Emergency Medicine | 2799 W Grand Blvd, Cfp 258, Detroit, MI 48202-2689 | 2019-03-24 |
| 1487005831 | Mohamed Serhan Hamam | Emergency Medicine | 1350 W Bethune St Apt 1908, Detroit, MI 48202-2667 | 2016-06-28 |
| 1548618036 | Mark Molnar | Emergency Medicine | 4201 Staint Antoine 6g Uhc, Detroit, MI 48201 | 2016-05-25 |
| 1871911321 | Brandon Charles Busuito | Emergency Medicine | 3909 Woodward Ave Apt 302, Detroit, MI 48201-2088 | 2014-04-02 |
| 1477816346 | Michael Khalil | Emergency Medicine | 4201 St Antoine Ste 3r, Detroit, MI 48201-1446 | 2012-06-16 |
| 1346521457 | Ralphe Bou Chebl | Emergency Medicine | 1350 W Bethune St Apt 1106, Detroit, MI 48202-2664 | 2011-09-01 |
| 1407144942 | Megan Dougherty | Emergency Medicine | 4201 St Antoine Uhc 9c, Detroit, MI 48201 | 2011-07-19 |
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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.