DR. TIMOTHY PETER BOUFFORD (NPI# 1811991177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811991177 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY PETER BOUFFORD |
| Credential | M.D. |
| Practice Address |
15855 19 Mile Rd Henry Ford Macomb Clinton Twp MI 48038-3504 |
| Mailing Address |
36115 Schoolcraft Rd Livonia MI 48150-1216 |
| Practice Telephone | 7344640887 |
| Practice Fax Number | 7344020254 |
| Mailing Telephone | 7344640887 |
| Mailing Fax Number | 7344020254 |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2014-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301062476 | MI | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 4301062476 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NPI # | 1811991177 | 01 |
| MI | 4846333 | 05 | |
| MI | BCBS CPIN # | 70-0-F32947-0 | 01 |
| MI | BCBSM | TB062476 | 01 |
| Street Address |
15855 19 MILE RD HENRY FORD MACOMB |
| City | CLINTON TWP |
| State | MI |
| Zip Code | 48038-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144857400 | Brent Geers | Orthopaedic Surgery | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-26 |
| 1245867118 | Michael Sochacki | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-23 |
| 1184259459 | Christina Lynn James | Nurse Practitioner | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-07 |
| 1417596396 | Amanda Marie Disanto | Nurse Anesthetist, Certified Registered | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-12-25 |
| 1114566189 | Jeffrey M Kirby | Nurse Anesthetist, Certified Registered | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-12-23 |
| 1164071783 | Ryan Amber Beebe | Nurse Practitioner | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-09-06 |
| 1215590583 | Sharan Mullen | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-04-22 |
| 1669934873 | Haley Svrcina Lehman | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-04-05 |
| 1336600311 | Joseph Gerald Lucido | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-03-30 |
| 1205397650 | Alexander Kuang-tsu Lu | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013296771 | Kavyashri Kodlipet Jagadeesh | Internal Medicine | 37399 Garfield Rd Ste 106, Clinton Twp, MI 48036-3672 | 2011-08-12 |
| 1760790604 | Patricia Deloof Md Pllc | Internal Medicine | 35740 Harper Ave, Clinton Twp, MI 48035-3212 | 2010-09-14 |
| 1548408461 | Rodolfo Sia Yapchai | Internal Medicine | 37900 Saddle Lane, Clinton Twp, MI 48036 | 2009-01-30 |
| 1558497107 | Thomas Michael Cooper I | Internal Medicine | 43073 W Kirkwood Dr, Clinton Twp, MI 48038-1220 | 2007-02-26 |
| 1730220757 | Jagatbhai A Amin | Internal Medicine | 36232 Garfield Rd, Clinton Twp, MI 48035-1128 | 2007-02-11 |
| 1528089497 | Anu Duvoor | Internal Medicine | 15520 19 Mile Road, Suite 480, Clinton Twp, MI 48038-6332 | 2006-07-23 |
| 1518986801 | Ben Fajardo | Internal Medicine | 42850 Garfield Rd Ste 102, Clinton Twp, MI 48038-5026 | 2006-07-18 |
| 1427009166 | Mary Ellen Puls | Internal Medicine | 36333 Harper Ave, Clinton Twp, MI 48035-2958 | 2006-05-15 |
| 1154975928 | Hima B Doppalapudi | Internal Medicine | 36500 S Gratiot Ave, Clinton Twp, MI 48035-1772 | 2019-07-30 |
| 1578068482 | Jeanette Elizabeth Girard | Internal Medicine | 36500 S Gratiot Ave, Clinton Twp, MI 48035-1772 | 2018-03-25 |
| Find all providers in CLINTON TWP | ||||
| City | CLINTON TWP |
| Zip Code | 48038 |
Please comment or provide details below to improve the information on DR. TIMOTHY PETER BOUFFORD.
| 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.