SPECTRUM SURGICAL SPECIALIST PC (NPI# 1609286384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609286384 |
| Entity Type | Organization |
| Organization Name | SPECTRUM SURGICAL SPECIALIST PC |
| Practice Address |
6001 W Outer Dr Suite 320 Detroit MI 48235-2614 |
| Mailing Address |
3181 Troy Dr Troy MI 48083-5098 |
| Practice Telephone | 3139205543 |
| Mailing Telephone | 3139205543 |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-06 |
| Authorized Official Name | MANISH KHARE (M.D.) |
| Authorized Official Telephone | 3139205543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 4301086474 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE | 0N30540 | 01 |
| Street Address |
6001 W OUTER DR SUITE 320 |
| City | DETROIT |
| State | MI |
| Zip Code | 48235-2614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093780611 | Susan Elaine Harold | Internal Medicine | 6001 W Outer Dr, Suite 429, Detroit, MI 48235-2614 | 2006-02-17 |
| 1891396800 | Ashley Sentell | Nurse Practitioner | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2020-11-05 |
| 1841815974 | Heba Ahmed Elmadhoun | Pharmacist | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2020-06-15 |
| 1710495346 | Katherine Memisevic | Nurse Anesthetist, Certified Registered | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2018-01-17 |
| 1467985911 | Omar Elmadhoun | Student in an Organized Health Care Education/Training Program | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2017-04-11 |
| 1083161905 | Julia Marie Burkhardt | Physician Assistant | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2016-09-08 |
| 1902251879 | Mi Midwife | Advanced Practice Midwife | 6001 W Outer Dr, Suite #320, Detroit, MI 48235-2614 | 2016-04-28 |
| 1255708343 | Emily Bigas | Dietitian, Registered | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2015-08-25 |
| 1407237548 | Elise Wiersma Paulk | Nurse Practitioner | 6001 W Outer Dr, Suite 445, Detroit, MI 48235-2614 | 2015-06-15 |
| 1457754533 | Reina Brojan Pearson | Nurse Practitioner | 6001 W Outer Dr, Suite 114, Detroit, MI 48235-2614 | 2014-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1629690565 | Faseeha Arshad Gondal | Student in an Organized Health Care Education/Training Program | Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 | 2020-05-14 |
| 1902428832 | Muhanad Abou Touk | Student in an Organized Health Care Education/Training Program | Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 | 2020-05-14 |
| 1780206730 | Ahmad Mismar | Student in an Organized Health Care Education/Training Program | Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 | 2020-05-13 |
| 1023630589 | Joao Paulo Fontana Bragagnollo | Student in an Organized Health Care Education/Training Program | 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 | 2020-05-07 |
| 1881216216 | Mohammad Awad Jaber | Student in an Organized Health Care Education/Training Program | 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 | 2020-05-07 |
| 1366064818 | Syeda Busmah Owais | Student in an Organized Health Care Education/Training Program | 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 | 2020-05-07 |
| 1184245680 | Sushmitha Nanja Reddy | Student in an Organized Health Care Education/Training Program | Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 | 2020-05-06 |
| 1972164796 | Jack Phillip Tomen | Student in an Organized Health Care Education/Training Program | Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 | 2019-06-24 |
| 1346809464 | Anusha Bapatla | Student in an Organized Health Care Education/Training Program | 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 | 2019-06-12 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366881096 | Jennifer Ashley Cirino | Surgery | 2799 W Grand Blvd # 126, Detroit, MI 48202-2689 | 2013-06-15 |
| 1073856035 | Asra Hashmi | Surgery | 4201 St.antoine Street, 6c, Uhc, Detroit, MI 48201 | 2013-03-28 |
| 1396086997 | Ryan E Shelden | Surgery | 6001 West Outer Drive, Detroit, MI 48235 | 2013-03-06 |
| 1598029985 | Uzma Naim | Surgery | 200 Riverfront Dr, Apt 23c, Detroit, MI 48226-4525 | 2012-06-29 |
| 1336435494 | Inna Neyman Lobeck | Surgery | 4201 St. Antoine, 6c-university Health Center, Department of Surgery, Wayne State University, Detroit, MI 48201 | 2011-06-27 |
| 1235434770 | Amer Ali Almohssen | Surgery | 4201 St. Antoine, 6th Floor, 313-577-5013, Detroit, MI 48201 | 2011-01-13 |
| 1407166432 | Majid Toseef Aized | Surgery | 9c,4201 St. Antoine Blvd, Graduate Medical Education,detroit Receiving Hospital, Detroit, MI 48201 | 2010-10-08 |
| 1104067552 | Furrukh Jabbar | Surgery | 1 St Antoine Street, Detroit Receiving Hospital, Detroit, MI 48201 | 2009-03-16 |
| 1497995641 | Todd Thornton Lavery | Surgery | 4160 John R St Ste 615, Detroit, MI 48201-2022 | 2009-03-01 |
| 1982851028 | Kaushik Mandal | Surgery | 6001 W Outer Dr Ste 300, Detroit, MI 48235-2626 | 2008-08-20 |
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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.