DOMINIC BRINK (NPI# 1417486234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417486234 |
| Entity Type | Individual |
| Full Name | DOMINIC BRINK |
| Credential | MD |
| Practice Address |
22201 Moross Rd 2nd Fl Cath Lab Detroit MI 48236 |
| Mailing Address |
22201 Moross Rd 2nd Fl Cath Lab Detroit MI 48236-2166 |
| Practice Telephone | 3133434612 |
| Mailing Telephone | 3133434612 |
| Mailing Fax Number | 3133438747 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2020-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301112927 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MI | Student, Health Care |
| Street Address |
22201 MOROSS RD 2ND FL CATH LAB |
| City | DETROIT |
| State | MI |
| Zip Code | 48236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760688 | Henry Grady Bone IIi | Internal Medicine | 22201 Moross Rd, Ste 260, Detroit, MI 48236-2175 | 2005-06-16 |
| 1790302396 | Zoheb Backer | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-30 |
| 1003432816 | Keerthana Reddy Banala | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 80, Detroit, MI 48236 | 2020-06-18 |
| 1013533918 | Sajithaa Varadarasa | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-17 |
| 1578188918 | Rida Jamal | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Detroit, MI 48236 | 2020-06-11 |
| 1669097952 | Inderpal Singh | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-11 |
| 1376168732 | Mehdi Yavari | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Detroit, MI 48236 | 2020-06-11 |
| 1548884414 | Krishna Chandra Mahat | Student in an Organized Health Care Education/Training Program | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-05 |
| 1508358540 | Vito Saracino | Internal Medicine | 22201 Moross Rd, Detroit, MI 48236-2169 | 2018-06-05 |
| 1457880718 | Marco Antonio Martinez | Obstetrics & Gynecology | 22201 Moross Rd, Suite 370, Detroit, MI 48236 | 2017-06-08 |
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| 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 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 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 |
| 1871053751 | Jacob Diskin | Internal Medicine | 4201 St. Antione, Uhc 9c, Detroit, MI 48201 | 2019-03-25 |
| 1770092272 | Daniel Saul Mizrahi | Internal Medicine | 7633 E Jefferson Ave Ste 250, Detroit, MI 48214-3731 | 2017-09-27 |
| 1700304912 | Premier Care Rehabilitation | Internal Medicine | 10641 W Mcnichols Rd, Detroit, MI 48221-2303 | 2017-09-07 |
| 1427400431 | Aryan Shiari | Internal Medicine | 3990 John R St Rm Room3925, Detroit, MI 48201-2018 | 2016-07-01 |
| 1700236478 | Osh-mi Physicians Group PC | Internal Medicine | 18600 Fenkell St, Detroit, MI 48223-2315 | 2016-06-14 |
| 1184070815 | Khalil Ibrahim Bourji | Internal Medicine | 4201 Saint Antoine St Ste 4h, Detroit, MI 48201 | 2016-05-12 |
| 1124403779 | Swetha Edla | Internal Medicine | 22101 Moross Road Pb Suite 50, Detroit, MI 48236 | 2015-07-24 |
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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.