DR. STANLEY MICHAEL POLECK (NPI# 1811073737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811073737 |
| Entity Type | Individual |
| Full Name | DR. STANLEY MICHAEL POLECK |
| Credential | D.O. |
| Practice Address |
19335 Grand River Ave Detroit MI 48223-1201 |
| Mailing Address |
22956 Woodrising Ln Farmington Hills MI 48335-3873 |
| Practice Telephone | 3137948780 |
| Practice Fax Number | 3137948790 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101006113 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 5101006113 | 01 |
| MI | 4246537 | 05 | |
| MI | DEA | AP4970732 | 01 |
| Street Address |
19335 GRAND RIVER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48223-1201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952770380 | Marie Chris Eamon | Nurse Practitioner | 19335 Grand River Ave, Detroit, MI 48223-1201 | 2015-09-16 |
| 1083759567 | Stanley M Poleck Do Pllc | Family Medicine | 19335 Grand River Ave, Detroit, MI 48223-1201 | 2007-02-21 |
| 1699851519 | Annemarie Poleck | Family Medicine | 19335 Grand River Ave, Detroit, MI 48223-1201 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366946659 | From Heavens Joy Assisted Care Support Services LLC | Social Worker | 14179 Evergreen Rd, Detroit, MI 48223 | 2018-03-21 |
| 1164921144 | Kyara Mccraney | Licensed Practical Nurse | 12725 Riverview St, Detroit, MI 48223 | 2018-02-06 |
| 1922516384 | Cynthia Clair Reese | Nursing Home Administrator | 22625 Glendale, Det, MI 48223 | 2018-01-18 |
| 1629590609 | Marie Davis | Nursing Care | 14049 Minock St, Detroit, MI 48223 | 2017-07-12 |
| 1740726488 | Tanisha Smith | Behavior Technician | 14620 Faust Ave, Detroit, MI 48223 | 2017-01-18 |
| 1518418730 | Tamica K Boyd | Emergency Medical Technician, Basic | 15890 Lamphere, Detroit, MI 48223 | 2016-10-24 |
| 1831596832 | Walter Ector | Counselor | 14243 Minock, Detroit, MI 48223 | 2014-11-20 |
| 1336568542 | Sheryl A Ali | Registered Nurse | 12811 Hazelton Street, Detroit, MI 48223 | 2014-04-15 |
| 1255667556 | Abyssinia Love Knot Physical Therapy LLC | Physical Medicine & Rehabilitation | 15340 Southfield Freeway, Suite 1-a, Detroit, MI 48223 | 2009-10-22 |
| 1629243902 | Glenda Faye Smith | Massage Therapist | 15041 Faust, Detroit, MI 48223 | 2008-04-28 |
| Find all providers in zip 48223 | ||||
| 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 |
| 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.