DAVID VANDAM LLC (NPI# 1417389396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417389396 |
| Entity Type | Organization |
| Organization Name | DAVID VANDAM LLC |
| Practice Address |
5130 Coolidge Hwy Suite 120 Royal Oak MI 48073-1001 |
| Mailing Address |
6985 Miller Dr Warren MI 48092-4725 |
| Practice Telephone | 2486580878 |
| Practice Fax Number | 2484350930 |
| Mailing Telephone | 5862643500 |
| Mailing Fax Number | 5862643495 |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-11-11 |
| Authorized Official Name | DAVID VAN DAM (OWNER) |
| Authorized Official Telephone | 2484215876 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704115131 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5130 COOLIDGE HWY SUITE 120 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922094689 | Kenneth Wayne Gahry | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2005-09-27 |
| 1679921787 | Maegen Mandeville | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2016-05-31 |
| 1437544772 | Royal Oak Medical Center PC | Internal Medicine | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2015-04-03 |
| 1477974103 | Kanupriya Kapoor | Physical Therapist | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2013-12-24 |
| 1952737645 | Martin Zarski | Nurse Anesthetist, Certified Registered | 5130 Coolidge Hwy, Suite 120, Royal Oak, MI 48073-1001 | 2013-09-25 |
| 1720429251 | Margarete Liles LLC | Nurse Anesthetist, Certified Registered | 5130 Coolidge Hwy, Suite 120, Royal Oak, MI 48073-1001 | 2013-07-12 |
| 1881032407 | Maureen Therese Romanchik | Nurse Practitioner | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2013-06-05 |
| 1619228061 | Kelly L Hess | Nurse Practitioner | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2012-09-25 |
| 1922396936 | Rashmi Patel | Physical Therapist | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2011-07-12 |
| 1447543780 | Reshma Salvi | Physical Therapist | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2011-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467840512 | Jordan Ford | Nurse Anesthetist, Certified Registered | 610 N Altadena Ave, Royal Oak, MI 48067-1952 | 2014-12-23 |
| 1699951095 | Jennifer Lynn Gruits | Nurse Anesthetist, Certified Registered | 2216 Brockton Ave, Royal Oak, MI 48067-3568 | 2008-01-15 |
| 1851429120 | Joseph Nelson | Nurse Anesthetist, Certified Registered | 3601 W. 13 Mile, 400 Fsc, Royal Oak, MI 48073-6769 | 2007-03-01 |
| 1558339960 | Lisa Licavoli | Nurse Anesthetist, Certified Registered | 3601 W 31 Mile Rd, 400 Fsc - PCs, Royal Oak, MI 48073-6769 | 2006-03-10 |
| 1790751683 | Virginia Hagood | Nurse Anesthetist, Certified Registered | 3601 W. 13 Mile Rd, 400 Fsc-pcs, Royal Oak, MI 48073-6769 | 2006-02-28 |
| 1730723321 | Marissa Jeanine Demartino | Nurse Anesthetist, Certified Registered | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-11-06 |
| 1720639925 | Stefanie Marie Glasgow | Nurse Anesthetist, Certified Registered | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-09-28 |
| 1508414541 | Renzo Arnold | Nurse Anesthetist, Certified Registered | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-09-03 |
| 1548728926 | Paige Morgan Vannoy | Nurse Anesthetist, Certified Registered | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-03-05 |
| 1790249118 | Jacob Bradford Hekker | Nurse Anesthetist, Certified Registered | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-01-30 |
| Find all providers in ROYAL OAK | ||||
Please comment or provide details below to improve the information on DAVID VANDAM LLC.
| 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.