DR. ROBERT M SODERSTROM (NPI# 1548294176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548294176 |
| Entity Type | Individual |
| Full Name | DR. ROBERT M SODERSTROM |
| Credential | M.D. |
| Practice Address |
G-5131 West Bristol Rd Ste A Flint MI 48507 |
| Mailing Address |
5131 W Bristol Rd Ste A Flint MI 48507-2970 |
| Practice Telephone | 8107332090 |
| Practice Fax Number | 8107330387 |
| Mailing Telephone | 8107332090 |
| Mailing Fax Number | 6304951770 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-07-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4301032434 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | HEALTHPLUS OF MICHIGAN | 0771592 | 01 |
| MI | 1421419 | 05 | |
| MI | BLUE CARE NETWORK MICHIGA | 0257159 | 01 |
| Street Address |
G-5131 WEST BRISTOL RD STE A |
| City | FLINT |
| State | MI |
| Zip Code | 48507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
| 1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
| 1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
| 1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
| 1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
| 1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
| Find all providers in zip 48507 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407254782 | Dermatology Center of Michigan Pllc | Dermatology | 5084 Villa Linde Pkwy Ste 5, Flint, MI 48532-3422 | 2014-12-18 |
| 1043484421 | Robert M Soderstrom Md PC | Dermatology | G5131 W Bristol Rd, Suite A, Flint, MI 48507 | 2008-04-17 |
| 1689759839 | Alan R Berlin | Dermatology | 1079 Professional Dr, Flint, MI 48532 | 2006-10-26 |
| 1770524886 | Walter F Barkey | Dermatology | 2256 W Hill Rd, Flint, MI 48507-4655 | 2006-06-09 |
| 1124293147 | Scott B Karlene Md PC | Dermatology | 1352 S Linden Rd, Flint, MI 48532-4185 | 2008-04-30 |
| 1699940619 | Kevin J Gaffney Md PC | Dermatology | 1352 S Linden Rd, Flint, MI 48532-4185 | 2008-04-30 |
| 1255511820 | Alan R. Berlin, D.o.p.c. | Dermatology | 1079 Professional Dr, Flint, MI 48532-3636 | 2007-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595616 | Diamond Dermatology, Pllc. | Dermatology | 3206 N Main St, Royal Oak, MI 48073-3424 | 2020-07-16 |
| 1477179174 | Alicia Scopis | Dermatology | 50505 Schoenherr Rd Ste 325, Shelby Township, MI 48315-3142 | 2020-06-18 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
| 1245744242 | Maureen Cliffel Do Pllc | Dermatology | 26454 Woodward Ave Ste 200, Royal Oak, MI 48067-0969 | 2017-11-29 |
| 1306375365 | Lindsay Christina El Awadi | Dermatology | 50182 Schoenherr Rd, Shelby Twp, MI 48315-3136 | 2017-06-05 |
| 1396278099 | Sasank Konda | Dermatology | 3031 W. Grand Blvd., 8th Floor, Dept. of Dermatology, Detroit, MI 48202 | 2017-04-10 |
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1679955041 | Luke D Killpack | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2015-06-22 |
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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.