HENRI GODBOLD (NPI# 1407012834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407012834 |
| Entity Type | Individual |
| Full Name | HENRI GODBOLD |
| Other Name | HENRI GODBOLD |
| Credential | M.D |
| Practice Address |
3956 Mount Elliott St Detroit MI 48207-1841 |
| Mailing Address |
Po Box 721471 Berkley MI 48072-0471 |
| Practice Telephone | 3139254540 |
| Practice Fax Number | 3139254606 |
| Mailing Telephone | 3133002024 |
| Mailing Fax Number | 8883508965 |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2020-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301080800 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
4301080800 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 4301080800 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 195 W 9 Mile Rd, Ferndale, MI 482202914 | 2487731829 | 8553693300 |
| 20901 W 7 Mile Rd, Detroit, MI 482191904 | 3135322000 | 3135382609 |
| 9021 Joseph Campau St, Hamtramck, MI 482123726 | 3138711926 | 3138711964 |
| Street Address |
3956 MOUNT ELLIOTT ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619985058 | Professional Medical Center PC | Family Medicine | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2006-08-03 |
| 1063982312 | Ellen L Anderson | Registered Nurse | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2018-11-29 |
| 1134620008 | Laneice Jones | Social Worker | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2018-02-26 |
| 1306271135 | Cassandra Rena Viney | Nurse Practitioner | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2013-09-11 |
| 1043561277 | Temitope Oladokun Olagbaiye | Nurse Practitioner | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2012-09-27 |
| 1497004527 | Kasheena T Shropshire | Nurse Practitioner | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2012-09-05 |
| 1568695179 | Angela Michele Allen | Nurse Practitioner | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2009-08-29 |
| 1891922613 | Omosalewa Itauma | Obstetrics & Gynecology | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2009-06-18 |
| 1811044118 | Pro Care Helath Plan Inc. | Health Maintenance Organization | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2007-01-05 |
| 1093725186 | Usha L Doshi | Pediatrics | 3956 Mount Elliott St, Detroit, MI 48207-1841 | 2006-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427419662 | Shoaib A Rasheed | Internal Medicine | 250 Mcdougall St, Detroit, MI 48207-4291 | 2016-03-16 |
| 1326274473 | Saket Anand Saxena | Internal Medicine | 1 Ford Pl # 2f51, Detroit, MI 48202-3450 | 2009-06-03 |
| 1962572404 | Medical Care of Michigan LLC | Internal Medicine | 10330 W 7 Mile Rd, Detroit, MI 48221-1963 | 2006-11-09 |
| 1700827680 | Vasan H Deshikachar | Internal Medicine | 11803 Grand River Ave, Detroit, MI 48204-1810 | 2006-06-09 |
| 1386025930 | Omnia Dia Awad | Internal Medicine | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2015-06-09 |
| 1205275542 | Hasan Arrat | Internal Medicine | 7430 2nd Ave Ste 210, Detroit, MI 48202-2705 | 2013-06-20 |
| 1588732028 | Gwendolyn R. Graddy | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-12-01 |
| 1629082672 | Laxmi Raman Chigurupati | Internal Medicine | 4646 John R St, Detroit, MI 48201-1916 | 2006-07-27 |
| 1164451951 | Barbara Jean Siepierski | Internal Medicine | 4646 John R St, 11g, Detroit, MI 48201-1916 | 2006-07-02 |
| 1770527517 | Anchor Senior Medical Services Pllc | Internal Medicine | 11803 Grand River Ave, Detroit, MI 48204-1810 | 2006-06-15 |
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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.