RYAN MATTHEW OUILLETTE (NPI# 1750643235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750643235 |
| Entity Type | Individual |
| Full Name | RYAN MATTHEW OUILLETTE |
| Credential | M.D. |
| Practice Address |
23550 Park St Ste 100 Dearborn MI 48124-2592 |
| Practice Telephone | 3137300500 |
| Practice Fax Number | 3137300606 |
| Mailing Telephone | 3137300500 |
| Mailing Fax Number | 3137300606 |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2019-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
4301111844 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MICHIGAN BUREAU OF PROFESSIONAL LICENSING | 4301111844 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 36475 Five Mile Rd Ste 125, Livonia, MI 481541971 | 3137300500 | 3137300606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760016000 | Ryan Ouillette | Clinic/Center | 9500 Gilman Dr, La Jolla, CA 92093-5004 | 2020-02-25 |
| Street Address |
23550 PARK ST STE 100 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336111517 | Juan A Estigarribia | Internal Medicine | 23550 Park St, Dearborn, MI 48124-2592 | 2006-02-02 |
| 1225338445 | Allison Housner | Physical Therapist | 23550 Park St, Ste. 100, Dearborn, MI 48124 | 2010-10-22 |
| 1346441904 | Quality Eye Care PC | Specialist | 23550 Park St, Suite 200, Dearborn, MI 48124-2592 | 2007-05-30 |
| 1336249689 | Douglas G Plagens | Orthopaedic Surgery | 23550 Park St, Ste. 100, Dearborn, MI 48124-2592 | 2006-09-25 |
| 1396845616 | Jeffrey Thomas Waldrop | Orthopaedic Surgery | 23550 Park St, Ste. 100, Dearborn, MI 48124-2592 | 2006-09-25 |
| 1275633596 | Matthew P Steffes | Orthopaedic Surgery | 23550 Park St, Ste 100, Dearborn, MI 48124-2592 | 2006-09-25 |
| 1346340684 | Gregory W Housner | Orthopaedic Surgery | 23550 Park St, Ste. 100, Dearborn, MI 48124-2592 | 2006-09-25 |
| 1336249663 | Michael J Geoghegan | Orthopaedic Surgery | 23550 Park St, Ste. 100, Dearborn, MI 48124-2592 | 2006-09-25 |
| 1629006465 | Vincent C Yu | Ophthalmology | 23550 Park St, Suite 200, Dearborn, MI 48124 | 2006-06-29 |
| 1093770588 | James Paul Simeone | Physical Therapy Assistant | 23550 Park St, Ste 101, Dearborn, MI 48124 | 2006-04-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528590635 | Mohamed Saad Md PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2017-03-29 |
| 1629332689 | Hussein A Saad Md PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2012-06-25 |
| 1467556993 | Marc J Milia Md PC | Orthopaedic Surgery | 21031 Michigan Ave, Dearborn, MI 48124-2339 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821472861 | Oakland University | Orthopaedic Surgery | 201 Athletics Ctr, Rochester, MI 48309 | 2015-07-18 |
| 1689871576 | Stacy Ann Frye | Orthopaedic Surgery | 3960 Patient Care Dr Ste 113, Lansing, MI 48911-4279 | 2007-07-02 |
| 1215075106 | Carl Henry Wierks | Orthopaedic Surgery | 1000 E Paris Ave Se Ste 215, Grand Rapids, MI 49546-3680 | 2007-02-02 |
| 1003909524 | Mfb Professional Services Inc | Orthopaedic Surgery | 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 | 2006-10-02 |
| 1598878266 | Abdallah Simaika | Orthopaedic Surgery | 2797 Applegate Rd, Po Box 55, Applegate, MI 48401-9752 | 2006-08-16 |
| 1689662405 | Richard M Howell | Orthopaedic Surgery | 370 N 120th Ave, Holland, MI 49424-2196 | 2005-10-06 |
| 1235121138 | Steven T Plomaritis | Orthopaedic Surgery | 28001 Schoenherr Rd, Suite 3, Warren, MI 48088-4396 | 2005-08-17 |
| 1457961716 | Justin Michael Schupbach | Orthopaedic Surgery | 24 Frank Lloyd Wright Dr Lbby A, Ann Arbor, MI 48105-9484 | 2020-08-03 |
| 1053945923 | Pure Performance Orthopedics & Sports Medicine | Orthopaedic Surgery | 27207 Lahser Rd Ste 108, Southfield, MI 48034-2168 | 2020-02-28 |
| 1396377131 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 | 2020-02-10 |
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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.