MOHSEN DJAMALI (NPI# 1407991615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407991615 |
| Entity Type | Individual |
| Full Name | MOHSEN DJAMALI |
| Credential | M.D. |
| Practice Address |
4870 W Clark Rd Suite 100a Ypsilanti MI 48197-1104 |
| Mailing Address |
Po Box 81936 Rochester MI 48308-1936 |
| Practice Telephone | 7344444063 |
| Practice Fax Number | 7346779841 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2013-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MD039115 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2111054-10 | 05 | |
| MI | BLUE CROSS BLUE SHIELD | 0105005402 | 01 |
| MI | BCN | P65533 | 01 |
| Street Address |
4870 W CLARK RD SUITE 100A |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245205541 | Emily W Bandera | Allergy & Immunology | 4870 W Clark Rd, # 202, Ypsilanti, MI 48197-1104 | 2006-02-21 |
| 1538517032 | Jennifer Aldea | Physician Assistant | 4870 W Clark Rd, Suite #201, Ypsilanti, MI 48197-1104 | 2016-05-25 |
| 1821497116 | Jordan Else | Nurse Practitioner | 4870 W Clark Rd, Ste 201, Ypsilanti, MI 48197-1104 | 2014-08-22 |
| 1255647350 | Michigan Hospice,inc. | Hospice Care, Community Based | 4870 W Clark Rd, Suite 100b, Ypsilanti, MI 48197-1104 | 2010-08-26 |
| 1740509116 | Physician Group | General Practice | 4870 W Clark Rd, Ste 100a, Ypsilanti, MI 48197-1104 | 2010-05-25 |
| 1053639146 | Midwest Travelers Health Service | Internal Medicine | 4870 W Clark Rd, Suite 204, Ypsilanti, MI 48197-1104 | 2010-05-13 |
| 1790017416 | Charles P Craig Md PC | Internal Medicine | 4870 W Clark Rd, Suite 204, Ypsilanti, MI 48197-1104 | 2010-02-05 |
| 1013140573 | Jay Ambey LLC | Pharmacy | 4870 W Clark Rd, Suite#108, Ypsilanti, MI 48197-1104 | 2009-09-01 |
| 1053577536 | Advanced Asthma Allergy & Immunology Care PC | Allergy & Immunology | 4870 W Clark Rd, Suite 202, Ypsilanti, MI 48197-1104 | 2008-08-04 |
| 1861650137 | Charles Krasnow | Psychiatry & Neurology | 4870 W Clark Rd, Suite #101, Ypsilanti, MI 48197-1104 | 2008-05-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982911830 | Heritage Medical Clinic Pplc | General Practice | 1159 E Michigan Ave Ste E, Ypsilanti, MI 48198-5807 | 2010-09-13 |
| 1023095296 | Zaheda Shafqat Ali | General Practice | 428 S Grove St, Ypsilanti, MI 48198-5662 | 2005-12-28 |
| 1851657365 | Adelina W Herrero Md Pllc | General Practice | 1159 E Michigan Ave Ste E, Ypsilanti, MI 48198-5807 | 2012-04-09 |
| 1740509116 | Physician Group | General Practice | 4870 W Clark Rd, Ste 100a, Ypsilanti, MI 48197-1104 | 2010-05-25 |
| 1821224908 | Home Care Medical Specialists Inc. | General Practice | 1159 E Michigan Ave, Suite E, Ypsilanti, MI 48198-5807 | 2009-06-03 |
| 1205098654 | Shi-yu Tan | General Practice | 3150 Packard Rd, Ypsilanti, MI 48197-1994 | 2008-06-26 |
| 1679734461 | Visiting Physicians Associates PC | General Practice | 3150 Packard Rd, Ypsilanti, MI 48197-1994 | 2008-06-24 |
| 1851426183 | Kimberly Evans Keller | General Practice | University Health Services, Eastern Michigan University, Ypsilanti, MI 48197-2207 | 2007-02-23 |
| 1497779649 | Walayat A Khan | General Practice | 1159 E Michigan Ave, Ste E, Ypsilanti, MI 48198-5807 | 2006-07-27 |
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| 1336602812 | Mk Certified, LLC | General Practice | 2140 Stone Rd, Ann Arbor, MI 48105-2535 | 2019-04-10 |
| 1215422555 | The Natural Momma Me Initiative | General Practice | 11000 W Mcnichols Rd Ste 212, Detroit, MI 48221-2389 | 2018-06-28 |
| 1881183028 | Silverstone Medical Group, Pllc | General Practice | 805 Oakwood Dr Ste 111, Rochester, MI 48307-1359 | 2018-05-03 |
| 1245739903 | Breanna Lee Brookens | General Practice | 1531 Barnard St, Saginaw, MI 48602-4902 | 2018-02-08 |
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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.