ISLAM BEIDOUN (NPI# 1508420597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508420597 |
| Entity Type | Individual |
| Full Name | ISLAM BEIDOUN |
| Practice Address |
2799 W Grand Blvd Detroit MI 48202 |
| Mailing Address |
2799 W Grand Blvd Detroit MI 48202-2608 |
| Practice Telephone | 3139162600 |
| Mailing Telephone | 3139162600 |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
4704282549 | MI | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
4704282549 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 912 N Gulley Rd, Dearborn, MI 481281551 | 3132832153 |
| Street Address |
2799 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132069 | Donna Prince | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2005-05-24 |
| 1790386704 | Alexandria L Blevins | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-05 |
| 1255932430 | Amy Katlyn Carion | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-04 | |
| 1871194415 | Alexandria Denise Roberts | Physical Therapist | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-11-02 |
| 1174121420 | John Charles Sanno | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-10-09 |
| 1932706991 | Fallon J Awe | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-02 |
| 1922615145 | Chelsea Elizabeth Owen | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1275130395 | Zana Latkovac | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1487260030 | Jessica Lee Moret | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-18 |
| 1932713237 | Lucas Costa Santos | Anesthesiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1811202310 | Ronda Lyn Bryant | Nurse Practitioner | 17600 Ryan Rd, Detroit, MI 48212-1155 | 2010-08-10 |
| 1104902915 | Kathleen Ann Brady | Nurse Practitioner | Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 | 2006-10-27 |
| 1619914199 | Sheryl Jean Marentette | Nurse Practitioner | 4646 John R St Ste A3118, Detroit, MI 48201-1916 | 2006-06-01 |
| 1952918740 | Lisa Colombo | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1558976928 | Ashley Mary Asmar | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2020-09-12 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1780205179 | Sabastan Patrick Knight | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-04-27 |
| 1225673114 | Marlon Nicdao | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2019-11-14 |
| 1265077408 | Megan Nicole Hodson | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2019-11-12 |
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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.