HOLLYWOOD PEDITRIC CLINIC (NPI# 1851568638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851568638 |
| Entity Type | Organization |
| Organization Name | HOLLYWOOD PEDITRIC CLINIC |
| Practice Address |
18811 E 10 Mile Rd Roseville MI 48066-3931 |
| Practice Telephone | 5867712340 |
| Practice Fax Number | 5867717323 |
| Mailing Telephone | 5867712340 |
| Mailing Fax Number | 5867717323 |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |
| Authorized Official Name | DR. REKHA SUDHIR SHAH (PRESIDENT) |
| Authorized Official Telephone | 5867712340 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301045777 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
18811 E 10 MILE RD |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-3931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215973086 | Rekha Sudhir Shah | Pediatrics | 18811 E 10 Mile Rd, Roseville, MI 48066-3931 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215368071 | Byron Johnson | Pediatrics | 1944 Shryer Ave W, Roseville, MN 55113-5415 | 2013-12-04 |
| 1528227253 | Judy A Cook | Pediatrics | 1856 Ridgeview Dr, Roseville, CA 95661-5835 | 2008-06-06 |
| 1235352220 | Rhonette Estelle Jackson | Pediatrics | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2007-04-10 |
| 1497892772 | Meghan Norton Davignon | Pediatrics | 1600 Eureka Rd Bldg C2nd, Roseville, CA 95661-3027 | 2007-01-30 |
| 1134291453 | David L Bannister | Pediatrics | 729 Sunrise Ave #501, Roseville, CA 95661 | 2006-11-14 |
| 1962473686 | Lakshmi Kumari Avala | Pediatrics | 902 Cirby Way, Roseville, CA 95661-4420 | 2006-01-30 |
| 1821090945 | Craig C Corp | Pediatrics | 3100 Douglas Blvd, Roseville, CA 95661-3866 | 2005-06-01 |
| 1023551751 | Olivia Hoang-kelada | Pediatrics | 2261 Douglas Blvd, Roseville, CA 95661-3831 | 2016-11-29 |
| 1083078091 | Patricia Tenold | Pediatrics | 1840 Sierra Gardens Dr, Roseville, CA 95661-2912 | 2016-04-06 |
| 1396139853 | Sarah Elizabeth Henshaw | Pediatrics | 3100 Douglas Blvd, Roseville, CA 95661 | 2015-03-23 |
| Find all providers in ROSEVILLE | ||||
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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.