TAMER NADY BOULES (NPI# 1679525539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679525539 |
| Entity Type | Individual |
| Full Name | TAMER NADY BOULES |
| Credential | M.D. |
| Practice Address |
22250 Providence Dr Suite 555 Southfield MI 48075-4825 |
| Practice Telephone | 2484245748 |
| Practice Fax Number | 2484431706 |
| Mailing Telephone | 2484245748 |
| Mailing Fax Number | 2484431706 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301072188 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PTAN | 0P33080 | 01 |
| MI | 4870974 | 05 |
| Street Address |
22250 PROVIDENCE DR SUITE 555 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710981071 | Anthony Edward Boutt | Obstetrics & Gynecology | 22250 Providence Dr, 408, Southfield, MI 48075-4825 | 2005-06-02 |
| 1871110015 | Abbas Chehab | Internal Medicine | 22250 Providence Dr, Southfield, MI 48075-4825 | 2020-07-04 |
| 1013531854 | Anicia Mirchandani | Radiology | 22250 Providence Dr, Southfield, MI 48075-4825 | 2020-06-06 |
| 1285258442 | Kidist Tamirat Arficho | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr, Southfield, MI 48075-4825 | 2020-06-03 |
| 1386268035 | Denas Andrijauskis | Surgery | 22250 Providence Dr, Southfield, MI 48075-4825 | 2020-05-28 |
| 1669030748 | Cyrus Garmo | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr, Southfield, MI 48075-4825 | 2019-06-03 |
| 1922661297 | Ammar Hassen Alsalahi | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr, Suite #601, Southfield, MI 48075-4814 | 2019-04-22 |
| 1265963797 | Cameron Whitler | Internal Medicine | 22250 Providence Dr, Suite 705, Southfield, MI 48075-4818 | 2017-03-26 |
| 1144671082 | Jessica Anne Hudson | Family Medicine | 22250 Providence Dr, Ste. 500, Southfield, MI 48075-4825 | 2016-06-22 |
| 1689024960 | Yessar Takruri | Internal Medicine | 22250 Providence Dr, Southfield, MI 48075-4825 | 2016-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 |
|---|---|---|---|---|
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| 1083672968 | Marc Gregory Webb | Surgery | 21701 W 11 Mile Rd, Southfield, MI 48076-3713 | 2006-05-02 |
| 1447878160 | Usa Vein Clinics of Detroit Pllc | Surgery | 29984 Telegraph Rd, Southfield, MI 48034-1355 | 2020-07-09 |
| 1235442732 | Pritham P. Reddy, Pllc | Surgery | 22250 Providence Drive, Suite #555, Southfield, MI 48152 | 2010-07-26 |
| 1922266808 | Wound Care Clinics of America PC | Surgery | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2008-05-28 |
| 1609077783 | Michigan Vascular Access, PC | Surgery | 21701 W 11 Mile Rd, Southfield, MI 48076-3713 | 2007-05-29 |
| 1134332919 | Pritham Pingli Reddy | Surgery | 22250 Providence Dr, Suite 555, Southfield, MI 48075-4825 | 2007-05-08 |
| 1215967872 | John W Sealey | Surgery | 16250 Northland Dr, Suite 310, Southfield, MI 48075-5205 | 2006-07-03 |
| 1235165770 | Victor Ubom | Surgery | 24111 Southfield Rd, Southfield, MI 48075-2817 | 2006-06-25 |
| 1871560979 | Kevin David Nolan | Surgery | 22250 Providence Dr, Suite 555, Southfield, MI 48075-4825 | 2006-03-07 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.