BARBARA ANN KARMANOS CANCER HOSPITAL (NPI# 1821518572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821518572 |
| Entity Type | Organization |
| Organization Name | BARBARA ANN KARMANOS CANCER HOSPITAL |
| Practice Address |
4100 John R St Detroit MI 48201-2013 |
| Practice Telephone | (800) 527-6266 |
| Mailing Telephone | 8005276266 |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |
| Authorized Official Name | BRIAN GAMBLE (CFO) |
| Authorized Official Telephone | 3135768935 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639661077 | Barbara Ann Karmanos Cancer Hospital | Pharmacy | 711 Stephenson Hwy, Troy, MI 48083-1128 | 2018-06-01 |
| 1013319201 | Barbara Ann Karmanos Cancer Hospital | Pharmacy | 4100 John R St, Suite Hp00rx, Detroit, MI 48201-2013 | 2014-09-19 |
| 1801203583 | Barbara Ann Karmanos Cancer Hospital | Dentist | 4100 John R St, Mail Code: Uh050t, Detroit, MI 48201-2013 | 2014-07-15 |
| 1316900277 | Barbara Ann Karmanos Cancer Hospital | General Acute Care Hospital | 4100 John R St, Detroit, MI 48201-2013 | 2006-04-10 |
| Street Address |
4100 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518966316 | Cynthia Hilda Marsack | Nurse Practitioner | 4100 John R St, Karmanos Cancer Ctr Midlevels, Detroit, MI 48201-2013 | 2005-07-14 |
| 1467062950 | Amy Josephine Skotzke | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2020-08-09 |
| 1700421294 | Nicole Gonzalez | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2019-11-08 |
| 1881237485 | Joseph Charles Ellul | Internal Medicine | 4100 John R St, Detroit, MI 48201-2013 | 2019-10-26 |
| 1841840113 | Thoracic Surgical Services, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4100 John R St, Detroit, MI 48201-2013 | 2019-09-18 |
| 1568016244 | Ellen Wong Dillard | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2019-07-30 |
| 1700340924 | Rita J Dibiase | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2019-01-23 |
| 1336634468 | Linsday Anne Cleveland | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2018-07-01 |
| 1407347214 | Diana Rudnev | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2018-05-29 |
| 1912408915 | Yaukpala Ina Gofan | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2018-02-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093780611 | Susan Elaine Harold | Internal Medicine | 6001 W Outer Dr, Suite 429, Detroit, MI 48235-2614 | 2006-02-17 |
| 1154306355 | John W Finn | Internal Medicine | 400 Mack Ave, Detroit, MI 48201-2136 | 2005-12-09 |
| 1689671455 | Lawrence G Lum | Internal Medicine | 4100 John R, Karmanos Cancer Center, Detroit, MI 48201-2013 | 2005-07-07 |
| 1881237485 | Joseph Charles Ellul | Internal Medicine | 4100 John R St, Detroit, MI 48201-2013 | 2019-10-26 |
| 1801273313 | Jayadev Reddy Mettu | Internal Medicine | 4201 Saint Antoine St, Uhc-2e, Detroit, MI 48201-2153 | 2015-05-05 |
| 1306286356 | Aparna Basu | Internal Medicine | 2799 W Grand Blvd, Cfp 5, Detroit, MI 48202-2608 | 2013-07-03 |
| 1003259045 | Maria Diab | Internal Medicine | 4201 Saint Antoine St, 5c-uhc, Detroit, MI 48201-2153 | 2013-04-09 |
| 1881953925 | Muhammad Usman | Internal Medicine | 4201 Saint Antoine St, Suite 2e, Detroit, MI 48201-2153 | 2012-05-10 |
| 1063707958 | Misako Nagasaka | Internal Medicine | 4100 John R St, Detroit, MI 48201-2013 | 2011-06-18 |
| 1851684393 | Hadeel Assad | Internal Medicine | 4100 John R St, Detroit, MI 48201-2013 | 2011-05-17 |
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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.