DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER (NPI# 1679808042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679808042 |
| Entity Type | Organization |
| Organization Name | DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER |
| Practice Address |
4201 Saint Antoine St Detroit MI 48201-2153 |
| Mailing Address |
Po Box 67000 Dept 614150 Detroit MI 48267-4150 |
| Practice Telephone | 3137454622 |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |
| Authorized Official Name | GLORIA LARKINS (VICE PRESIDENT OF MICHIGAN) |
| Authorized Official Telephone | 3137452117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801857362 | Detroit Receiving Hospital and University Health Center | General Acute Care Hospital | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2006-03-31 |
| Street Address |
4201 SAINT ANTOINE ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760477871 | John Mckay Perkowski | Nurse Anesthetist, Certified Registered | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2005-09-14 |
| 1013517028 | Madappulli Arachchige Wickrama | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-10-28 |
| 1134731466 | Helda Bacall | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-08-18 |
| 1568088680 | Michelle De Varennes | Physician Assistant | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-24 |
| 1235754144 | Saren Yeranosian | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-16 |
| 1083239230 | Jacqueline Ferraro-jaworski | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-13 |
| 1770107617 | Zamaan Sayeed Sohel | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-06 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1487276721 | Andrew R Kumar | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-09 |
| 1598386005 | Kayla Richelle Robinson | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477903904 | Abed Yakan | Dentist | 2700 Martin Luther King Jr. Blvd., 358, Detroit, MI 48208-2576 | 2016-06-15 |
| 1932308566 | Haissam A Kanaan | Dentist | Oral and Maxillofacial Surgery - Uhc 2f, 4201 St. Antoine Street, Detroit, MI 48201 | 2007-07-13 |
| 1912035817 | Suzanne Pasternak | Dentist | 4201 Saint Antoine St Ste 2f, Detroit, MI 48201-2153 | 2007-03-01 |
| 1619479763 | Amir Allhaji | Dentist | 4201 Saint Antoine St, Detroit, MI 48201 | 2018-03-05 |
| 1306380654 | Deepthy Nair | Dentist | 2700 Martin Luther King Jr Blvd, Department of Oral and Maxillofacial Surgery, Detroit, MI 48208-2576 | 2016-12-06 |
| 1629510482 | Dds-tapestry | Dentist | 7633 E Jefferson Ave, Ste 200, Detroit, MI 48214-3730 | 2016-11-10 |
| 1164829438 | David Scott Coviak | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-12-02 |
| 1124428198 | Matthew Cannavo | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-08-27 |
| 1023442399 | Ibrahim El Deeb Zakhary | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2013-08-22 |
| 1881971398 | Helena Michelle Perez | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2011-11-11 |
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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.