ALIS DESPINA VIDINAS (NPI# 1720299837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720299837 |
| Entity Type | Individual |
| Full Name | ALIS DESPINA VIDINAS |
| Credential | MD |
| Practice Address |
4401 Conner St Detroit MI 48215-2201 |
| Mailing Address |
6435 Westmoor Rd Bloomfield Hills MI 48301-1362 |
| Practice Telephone | 3138231324 |
| Mailing Telephone | 8105840228 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301088272 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4401 CONNER ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48215-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144318924 | Chantal Georges | Pharmacist | 4401 Conner St, Detroit, MI 48215-2201 | 2006-10-10 |
| 1669023057 | Latoya Nicole Cosey | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2019-09-26 |
| 1912412032 | Charllita Charmaine Rodgers | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-12 |
| 1770098907 | Tawana Nicole Carter | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-11 |
| 1043725450 | Gregory Lamont Richardson Jr. | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-07 |
| 1912412438 | Marquita Jones | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-06 |
| 1962917476 | Shondra Tinsley | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-06 |
| 1689189136 | Candsi E-nae Mcceary | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-06 |
| 1720593254 | Delisha Melvinia Montgomery | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-06 |
| 1508371063 | Sandra Annette Patterson | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2017-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073035473 | Creative Empowerment Counseling Services, LLC | Community/Behavioral Health | 214 Manistique, Detroit, MI 48215 | 2017-07-07 |
| 1801323530 | Tanya Wade | Social Worker | 12800 E Warren, Detroit, MI 48215 | 2017-05-12 |
| 1992164289 | Juanita Johnson | Counselor | 13336-40 E. Warren Ave, Detroit, MI 48215 | 2016-02-16 |
| 1629476379 | Northeast Guidance Center | Community/Behavioral Health | 12800 Warren, Detroit, MI 48215 | 2014-12-11 |
| 1407253412 | Conner Pharmacy LLC | Pharmacy | 4673 Conner Street, Detroit, MI 48215 | 2014-11-20 |
| 1053734285 | Dawne Robinson | Counselor | 2995 Conner St, Detroit, MI 48215 | 2014-01-23 |
| 1790065357 | Michelle Miller | Counselor | 2900 Conner, Bldg. A, Detroit, MI 48215 | 2011-08-26 |
| 1710286836 | Northeast Guidance Center | Community/Behavioral Health | 2900 Conner St, Ste A, Detroit, MI 48215 | 2011-03-16 |
| 1871892992 | Lisa Nicole Marszalec | Counselor | 12800 East Warren Ave, Detroit, MI 48215 | 2011-03-16 |
| 1881845014 | Deborah A Caldwell | Nutritionist | 13340 E Warren, Detroit, MI 48215 | 2008-10-07 |
| Find all providers in zip 48215 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194354811 | Lorie Ann Turner | Family Medicine | 1728 Sheridan St, Detroit, MI 48214-2410 | 2020-04-04 |
| 1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
| 1508326687 | Randi Nguyen | Family Medicine | 22151 Moross Rd Ste 212, Detroit, MI 48236-2177 | 2019-03-23 |
| 1982194338 | Green Cross Medical Center PC | Family Medicine | 18041 Greenfield Rd, Detroit, MI 48235-3120 | 2018-05-11 |
| 1205339306 | Conant Family Care Pllc | Family Medicine | 3611 Carpenter St Ste 5, Detroit, MI 48212-2784 | 2018-03-14 |
| 1801303086 | St Mary Mercy Physician Practices | Family Medicine | 5555 Conner St Ste 2691, Detroit, MI 48213-3812 | 2018-01-09 |
| 1427408376 | Raquel Orlich | Family Medicine | 1620 Michigan Ave Ste 125, Detroit, MI 48216-1493 | 2016-06-21 |
| 1295181543 | Ammar Charestan | Family Medicine | 6071 Outer Dr W, Detroit, MI 48235 | 2016-05-05 |
| 1629423652 | Rajni Parmar | Family Medicine | 6001 W Outer Dr Ste 430, Detroit, MI 48235-2626 | 2016-04-27 |
| 1265886733 | Benjamin Abraham | Family Medicine | One Ford Place 2e, Henry Ford Hospital, Department of Family Medicine, Detroit, MI 48202 | 2016-04-20 |
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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.