STEPHANIE JUDD (NPI# 1831328707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831328707 |
| Entity Type | Individual |
| Full Name | STEPHANIE JUDD |
| Credential | MD |
| Practice Address |
4646 John R St 11m-gas Detroit MI 48201-1916 |
| Mailing Address |
4646 John R Street 11m-gas John D. Dingell Va Medical Center Detroit MI 48201 |
| Practice Telephone | 3135761000 |
| Practice Fax Number | 3135761237 |
| Mailing Telephone | 3135761000 |
| Mailing Fax Number | 3135761237 |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2016-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
4301094318 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033772272 | Stephanie Judd | Psychologist | 3901 Rosemary St, Chevy Chase, MD 20815-5223 | 2019-04-14 |
| 1295035798 | Stephanie Rachel Judd | Counselor | 6509 S Santa Fe Dr, Littleton, CO 80120-2910 | 2010-10-30 |
| Street Address |
4646 JOHN R ST 11M-GAS |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
| 1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
| 1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
| 1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
| 1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
| 1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
| 1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
| 1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
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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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1437172749 | Edward A Clay | Internal Medicine | 20001 Greenfield Rd, Suite 6, Detroit, MI 48235-1870 | 2006-07-26 |
| 1992230114 | Kajali Mishra | Internal Medicine | 2799 W. Grand Boulevard, Henry Ford Hospital, Medical Education Department, Detroit, MI 48202 | 2017-04-25 |
| 1669823902 | Suraj Suresh | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2016-06-28 |
| 1063733111 | Kirthi Konda Lilley | Internal Medicine | 4646 John R St, 11m-gas, Detroit, MI 48201-1916 | 2010-06-11 |
| 1467770255 | Ashina Deepika Singh | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2010-05-04 |
| 1760650006 | Suneetha V Duttala | Internal Medicine | 3990 John R St, 6 Hudson, Detroit, MI 48201-2018 | 2008-02-20 |
| 1700084712 | Radhika Aggarwal | Internal Medicine | 2799 W Grand Blvd, K7, Detroit, MI 48202-2608 | 2007-07-11 |
| 1457560161 | Jeffrey Christian Formoso Tang | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-05-21 |
| 1528180601 | Reena Salgia | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-04-06 |
| 1679693915 | Robert Luis Pompa | Internal Medicine | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-03-30 |
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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.