GAURAV BHALLA (NPI# 1457616120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457616120 |
| Entity Type | Individual |
| Full Name | GAURAV BHALLA |
| Credential | M.D. |
| Practice Address |
4190 24th Ave Ste 201 Fort Gratiot MI 48059-3884 |
| Practice Telephone | (810) 216-4200 |
| Mailing Telephone | (810) 216-4200 |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2017-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301100838 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
4301100838 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4190 24TH AVE STE 201 |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059-3884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1396756615 | Blue Water Family Dentistry PC | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059 | 2006-08-11 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| Find all providers in zip 48059 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1902281736 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Ste 206, Fort Gratiot, MI 48059-3882 | 2015-07-22 |
| 1942615414 | Mercy Surgery Care Network | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2014-06-24 |
| 1740424001 | Rashim K Gupta | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2009-04-29 |
| 1669454559 | Endocrinology and Diabetes Center of Port Huron Pllc | Internal Medicine | 4190 24th Ave, Suite: 201, Fort Gratiot, MI 48059-3882 | 2005-11-16 |
| 1427044981 | Sushma Reddy | Internal Medicine | 4190 24th Ave, 206, Fort Gratiot, MI 48059-3882 | 2005-09-21 |
| 1922094556 | Butheinah A Al-sharafi | Internal Medicine | 4190 24th Ave, Suite:201, Fort Gratiot, MI 48059-3882 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851866172 | Grace Endocrine Services Pllc | Internal Medicine | 38864 Hilldale St, Clinton Township, MI 48036-2561 | 2018-10-13 |
| 1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
| 1003184748 | Khachorndej Vibhasiri | Internal Medicine | 732 Brookwood Walke, Bloomfield Hills, MI 48304-1900 | 2011-12-08 |
| 1427345065 | Ali Alexandru Achira | Internal Medicine | 4700 Greenfield Rd Ste 2c, Dearborn, MI 48126-4124 | 2011-07-04 |
| 1689979569 | Alzohaili Medical Consultants Md PC | Internal Medicine | 5250 Auto Club Dr Ste 200, Dearborn, MI 48126-2619 | 2011-01-24 |
| 1528377082 | Randall Whitcomb | Internal Medicine | 1527 High Hollow Dr, Ann Arbor, MI 48103-9621 | 2010-10-01 |
| 1639400799 | Kp Anandakrishnan Md PC | Internal Medicine | 5189 Venoy Rd, Wayne, MI 48184-2545 | 2010-01-28 |
| 1194962530 | Richard Michael Mortensen | Internal Medicine | 1301 Catherine St, 7641 Medical Sciences II, Ann Arbor, MI 48109-2026 | 2009-01-07 |
| 1235319872 | Endocrine Hospital Consultants, P.C. | Internal Medicine | 4782 Trailview, West Bloomfield, MI 48322-4572 | 2007-11-12 |
| 1174719025 | Center for Preventive Medicine PC | Internal Medicine | 20870 Mack Ave, Grosse Pointe Woods, MI 48236-1388 | 2007-09-24 |
| Find all providers with the same taxonomy | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
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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.