DETROIT MEDICAL CENTER (NPI# 1689815300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689815300 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Practice Address |
1431 Washington Blvd Apt 1814 Detroit MI 48226-1732 |
| Practice Telephone | 3135252072 |
| Mailing Telephone | 3135252072 |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2009-03-09 |
| Authorized Official Name | DR. JAMES G TYBURSKI (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 3137453487 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | DEA | BH26634487029 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1619332574 | Detroit Medical Center | Clinic/Center | 43205 Creekview Dr, Canton, MI 48187-3049 | 2015-12-19 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1326279803 | Detroit Medical Center | Special Hospital | 39180 Citation Pl, Apt # 35104, Farmington Hills, MI 48331-4901 | 2009-08-02 |
| 1356510085 | Detroit Medical Center | Clinic/Center | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2008-02-27 |
| 1699327429 | Detroit Medical Center | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2019-07-11 |
| 1205178761 | Detroit Medical Center | Psychiatry & Neurology | 3901 Beaubien St, Department of Neurology, Children's Hospital of Michiga, Detroit, MI 48201-2119 | 2013-03-22 |
| 1346508157 | Detroit Medical Center | Special Hospital | 4160 John R St, Detroit, MI 48201-2020 | 2012-04-30 |
| 1770853251 | Detroit Medical Center | Emergency Medicine | 6071 W Outer Dr, Emergency Medicine Department, Detroit, MI 48235-2624 | 2011-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DETROIT MEDICAL CENTER | 3990 John R St, Detroit, MI 48201-2018 |
| Street Address |
1431 WASHINGTON BLVD APT 1814 |
| City | DETROIT |
| State | MI |
| Zip Code | 48226-1732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065314 | Henr Y Ford Health System | Pharmacy | 1777 3rd. Ave, Detroit, MI 48226 | 2019-10-21 |
| 1912413386 | Vitalizing Care Consultants LLC | Home Health Aide | 1420 Washington Blvd Ste 301, Detroit, MI 48226 | 2017-12-21 |
| 1639699945 | Runners Transportation LLC | Non-emergency Medical Transport (VAN) | 111 Cadilac, Apt 16j, Detroit, MI 48226 | 2017-06-27 |
| 1174056857 | Nariman Nassiri | Student in an Organized Health Care Education/Training Program | 200 Riverfront Dr., Apt 11g, Detroit, MI 48226 | 2017-04-10 |
| 1982143384 | Strategic Operation Solutions | Case Management | 407 E. Fort St., Suite 407, Detroit, MI 48226 | 2017-02-17 |
| 1700329315 | Jacob Chaffee | Pharmacist | 600 E. Lafayette Blvd, Mail Code 512c, Detroit, MI 48226 | 2016-11-30 |
| 1487059325 | Lions Hearing Center of Michigan | Audiologist | 1326 St. Antoine, Detroit, MI 48226 | 2014-11-04 |
| 1811320336 | Ralph T Topolewski | Orthotist | 525 E.jefferson Ave, Detroit, MI 48226 | 2013-08-20 |
| 1689006488 | The Literacy Center | Non-emergency Medical Transport (VAN) | 645 Griswold Street, Suite 1300, Detroit, MI 48226 | 2013-08-02 |
| 1972834422 | Lydia J Commissaris | Nurse Practitioner | 45 W. Grand River Ave, Detroit, MI 48226 | 2010-01-22 |
| Find all providers in zip 48226 | ||||
| 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 |
| Find all providers in DETROIT | ||||
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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.