DETROIT MEDICAL CENTER (NPI# 1770853251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770853251 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Practice Address |
6071 W Outer Dr Emergency Medicine Department Detroit MI 48235-2624 |
| Mailing Address |
1431 Washington Blvd Apt 2714 Detroit MI 48226-1732 |
| Practice Telephone | 3139661020 |
| Mailing Telephone | 9137061307 |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2012-05-13 |
| Authorized Official Name | GRETCHEN BROWNLOW (PROGRAM COORDINATOR) |
| Authorized Official Telephone | 3139661020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| 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 |
| 1770869257 | Detroit Medical Center | Physician Assistant | 4201 Saint Antoine St Ste 6a, Drh University Health Center, Detroit, MI 48201-2153 | 2011-10-27 |
| 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 |
6071 W OUTER DR EMERGENCY MEDICINE DEPARTMENT |
| City | DETROIT |
| State | MI |
| Zip Code | 48235-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836806 | Select Specialty Hospital - Northwest Detroit Inc | Long Term Care Hospital | 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 | 2005-07-26 |
| 1356965198 | Anielle Ball | Registered Nurse | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-07 |
| 1427672708 | Nitesh Kumar Byrappa | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-03 |
| 1992327969 | Chandima Jinani Herath Mudiyanselage | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235 | 2020-05-13 |
| 1790307783 | Patrick Riedy | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-12 |
| 1518589878 | Nnadozie Okoroafor | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-09 |
| 1720609803 | Charmayne Gail Cooley | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1841811890 | Noren Din | Internal Medicine | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1962023069 | Haseeb Khan | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-29 |
| 1285255570 | Edward Park | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1629690565 | Faseeha Arshad Gondal | Student in an Organized Health Care Education/Training Program | Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 | 2020-05-14 |
| 1902428832 | Muhanad Abou Touk | Student in an Organized Health Care Education/Training Program | Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 | 2020-05-14 |
| 1780206730 | Ahmad Mismar | Student in an Organized Health Care Education/Training Program | Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 | 2020-05-13 |
| 1023630589 | Joao Paulo Fontana Bragagnollo | Student in an Organized Health Care Education/Training Program | 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 | 2020-05-07 |
| 1881216216 | Mohammad Awad Jaber | Student in an Organized Health Care Education/Training Program | 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 | 2020-05-07 |
| 1366064818 | Syeda Busmah Owais | Student in an Organized Health Care Education/Training Program | 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 | 2020-05-07 |
| 1184245680 | Sushmitha Nanja Reddy | Student in an Organized Health Care Education/Training Program | Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 | 2020-05-06 |
| 1972164796 | Jack Phillip Tomen | Student in an Organized Health Care Education/Training Program | Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 | 2019-06-24 |
| 1346809464 | Anusha Bapatla | Student in an Organized Health Care Education/Training Program | 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 | 2019-06-12 |
| Find all providers in zip 48235 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1851852263 | Samantha Allegra Chamberlain | Emergency Medicine | 22101 Moross Rd., Emergency Department, Detroit, MI 48236-2148 | 2019-03-28 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1417417536 | Joseph Julius Vermeulen | Emergency Medicine | 2799 W Grand Blvd, Cfp 258, Detroit, MI 48202-2689 | 2019-03-24 |
| 1487005831 | Mohamed Serhan Hamam | Emergency Medicine | 1350 W Bethune St Apt 1908, Detroit, MI 48202-2667 | 2016-06-28 |
| 1548618036 | Mark Molnar | Emergency Medicine | 4201 Staint Antoine 6g Uhc, Detroit, MI 48201 | 2016-05-25 |
| 1871911321 | Brandon Charles Busuito | Emergency Medicine | 3909 Woodward Ave Apt 302, Detroit, MI 48201-2088 | 2014-04-02 |
| 1477816346 | Michael Khalil | Emergency Medicine | 4201 St Antoine Ste 3r, Detroit, MI 48201-1446 | 2012-06-16 |
| 1346521457 | Ralphe Bou Chebl | Emergency Medicine | 1350 W Bethune St Apt 1106, Detroit, MI 48202-2664 | 2011-09-01 |
| 1407144942 | Megan Dougherty | Emergency Medicine | 4201 St Antoine Uhc 9c, Detroit, MI 48201 | 2011-07-19 |
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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.