PROVIDENCE PARK INTERNAL MEDICINE PC (NPI# 1487052619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487052619 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PARK INTERNAL MEDICINE PC |
| Practice Address |
26850 Providence Pkwy Suite 450 Novi MI 48374-1213 |
| Practice Telephone | 2488914074 |
| Mailing Telephone | 2488914074 |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | SUHA A QASIM (PRESIDENT) |
| Authorized Official Telephone | 2488914074 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301089716 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
26850 PROVIDENCE PKWY SUITE 450 |
| City | NOVI |
| State | MI |
| Zip Code | 48374-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354953 | Lara Azzi | Pediatrics | 26850 Providence Pkwy, Suite 455, Novi, MI 48374-1213 | 2005-05-27 |
| 1578096483 | Jordyn Havens | Counselor | 26850 Providence Pkwy, Ste 410, Novi, MI 48374-1213 | 2017-04-07 |
| 1740723659 | Carmela Wilder | Social Worker | 26850 Providence Pkwy, Suite 205, Novi, MI 48374-1213 | 2016-11-24 |
| 1518413210 | Adam Mcclafferty | Physical Therapist | 26850 Providence Pkwy, Suite 365, Novi, MI 48374-1213 | 2016-09-01 |
| 1336591973 | Jessica Wentworth | Nurse Practitioner | 26850 Providence Pkwy, Novi, MI 48374-1213 | 2016-07-07 |
| 1407233745 | Kha H. Ngo, D.o., P.l.l.c. | Internal Medicine | 26850 Providence Pkwy, Ste 350, Novi, MI 48374-1213 | 2015-05-06 |
| 1629455423 | Serge A. Sorser, M.d., P.l.l.c. | Internal Medicine | 26850 Providence Pkwy, Suite 350, Novi, MI 48374-1213 | 2015-04-30 |
| 1598161564 | Paul James Constantino | Podiatrist | 26850 Providence Pkwy, Suite 502, Novi, MI 48374-1213 | 2014-11-18 |
| 1306269436 | Northwest Eye Physicians, P.C. | Eyewear Supplier (Equipment, not the service) | 26850 Providence Pkwy, Suite 440, Novi, MI 48374-1213 | 2014-01-24 |
| 1306274493 | Elana Bodzin | Physical Therapist | 26850 Providence Pkwy, Suite 365, Novi, MI 48374-1213 | 2013-10-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902323884 | Jhansi Navuluri | Physical Therapist | 27579 Etrada Lane, Novi, MI 48374 | 2017-08-23 |
| 1609306422 | James Vanderhaeghen | Foster Care Agency | 24375 Homestead Ct, Novi, MI 48374 | 2017-06-14 |
| 1558810622 | Iryna Chaykivska | Nurse Anesthetist, Certified Registered | 47601 Grand River Avenue, Novi, MI 48374 | 2016-09-29 |
| 1477937944 | Joseph Smola | Chiropractor | 48000 Grand River Ave, Novi, MI 48374 | 2015-07-15 |
| 1881005114 | Alpha Medical Services PC | Internal Medicine | 26131, Sunbury Ct, Novi, MI 48374 | 2014-05-08 |
| 1043565443 | Jason J Rizqallah | Surgery | 47601 Grand River Ave # B136, Novi, MI 48374 | 2012-07-21 |
| 1780992628 | Khyati Patel | Internal Medicine | 26850 Providence Pkwy Ste 420, Novi, MI 48374 | 2010-09-14 |
| 1891963799 | Luann Marie Redmond | Social Worker | 50598 Montana, Novi, MI 48374 | 2008-02-13 |
| 1427249424 | Ajay V Raman | Anesthesiology | 24875 Novi Road #454, Novi, MI 48374 | 2007-08-05 |
| 1003948233 | Sam's Club Optical | Technician/Technologist | 27300 Wixon Road, Novi, MI 48374 | 2007-03-12 |
| Find all providers in zip 48374 | ||||
| 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 |
|---|---|---|---|---|
| 1336625540 | Vmd Primary Providers Eastern Michigan, PC | Internal Medicine | 27275 Haggerty Rd Ste 500, Novi, MI 48377-3635 | 2018-07-11 |
| 1528453305 | Jalal Georges Najem | Internal Medicine | 44760 Huntington Dr, Novi, MI 48375-2220 | 2015-03-30 |
| 1558775700 | Justin Di Rezze | Internal Medicine | 41850 W 11 Mile Rd Ste 207, Novi, MI 48375-1820 | 2014-06-16 |
| 1265850242 | Arun Kapur | Internal Medicine | 26850 Providence Pkwy Ste 505, Novi, MI 48374-1267 | 2014-04-07 |
| 1710312798 | All Patients Care Pllc | Internal Medicine | 31208 Beck Rd, Novi, MI 48377-1022 | 2013-09-09 |
| 1982970448 | Raveen Singh Rai | Internal Medicine | Po Box 247, Novi, MI 48376-0247 | 2012-03-29 |
| 1134414212 | Comprehensive Medical Practice PC | Internal Medicine | 24609 Cavendish Ave E, Novi, MI 48375-2362 | 2011-06-16 |
| 1437468063 | Progressive Primary Care PC | Internal Medicine | 24559 Perceval Ln, Novi, MI 48375-2355 | 2010-09-30 |
| 1780992628 | Khyati Patel | Internal Medicine | 26850 Providence Pkwy Ste 420, Novi, MI 48374 | 2010-09-14 |
| 1053627570 | Mohammad Alhaji | Internal Medicine | 39475 Lewis Dr Ste 200, Novi, MI 48377-2980 | 2010-08-21 |
| Find all providers in NOVI | ||||
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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.