DR. JONATHAN EDWARD BEAULAC (NPI# 1508132283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508132283 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN EDWARD BEAULAC |
| Credential | D.O. |
| Practice Address |
15855 Nineteen Mile Rd. Henry Ford Macomb Hospital Clinton Township MI 48038 |
| Mailing Address |
15855 Nineteen Mile Rd. Henry Ford Macomb Hospital Clinton Township MI 48038-6608 |
| Practice Telephone | 5867579707 |
| Mailing Telephone | 5867579707 |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2018-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 5101019890 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
5101019890 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
15855 NINETEEN MILE RD. HENRY FORD MACOMB HOSPITAL |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1801371315 | Matrix Medical Pllc | Internal Medicine | 52611 Blueridge Dr, Shelby Twp, MI 48316-2977 | 2018-10-01 |
| 1407364821 | Chesaning Comfort Care | Internal Medicine | 1800 W Brady Rd, Chesaning, MI 48616 | 2018-01-19 |
| 1992252191 | Vitality Home Health Services,inc. | Internal Medicine | 917 W Milham Ave, Portage, MI 49024-1248 | 2016-09-06 |
| 1427419662 | Shoaib A Rasheed | Internal Medicine | 250 Mcdougall St, Detroit, MI 48207-4291 | 2016-03-16 |
| 1710226477 | Nancy Couch | Internal Medicine | 791 Bradburn Ct, Northville, MI 48167-1027 | 2013-01-31 |
| 1639425879 | Anhkiet L Tran | Internal Medicine | 29736 Orion Ct, Farmington Hills, MI 48334-4114 | 2012-07-25 |
| 1700152014 | Nicholas Joseph | Internal Medicine | 24463 W 10 Mile Rd, Pace Southeast Michigan, Southfield, MI 48033-2931 | 2012-03-30 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1699055269 | Mobilized Docs of Michigan LLC | Internal Medicine | 23943 Industrial Park Dr, Farmington Hills, MI 48335-2862 | 2011-08-26 |
| 1780986018 | Spectrum Health Primary Care Partners | Internal Medicine | 727 Apple Ave, Holland, MI 49423-5405 | 2010-11-18 |
| Find all providers with the same taxonomy | ||||
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
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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.