GLENDON M. GARDNER (NPI# 1871669242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871669242 |
| Entity Type | Individual |
| Full Name | GLENDON M. GARDNER |
| Credential | M.D. |
| Practice Address |
6777 W Maple Rd West Bloomfield MI 48322-3013 |
| Practice Telephone | 2486617211 |
| Practice Fax Number | 2486616456 |
| Mailing Telephone | 2486617211 |
| Mailing Fax Number | 2486616456 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 063874 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 307008110 | 05 | |
| BLUE CROSS-BLUE CROSS | 700H262260 | 01 | |
| CHAMPUS-CHAMPUS | GG063874 | 01 | |
| COMMERCIAL-COMMERCIAL NUMBER | GG063874 | 01 |
| Street Address |
6777 W MAPLE RD |
| City | WEST BLOOMFIELD |
| State | MI |
| Zip Code | 48322-3013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497754816 | Lynne Camille Gafford | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2005-07-18 |
| 1740891639 | Teia Lee Irwin | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-08-13 |
| 1154947323 | Jaykumar Shah | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-23 |
| 1669098174 | Isaac Michael Peruski | Internal Medicine | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-20 |
| 1609490689 | Jessica Sassine Akl | Physician Assistant | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-04 |
| 1952922684 | Marie Giuseppa Diponio-hohl | Registered Nurse | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-05 |
| 1679194542 | Betsy Thomas | Registered Nurse | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-02 |
| 1952922841 | Hiba Nabil Issa | Pharmacist | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-01 |
| 1427692607 | Jenna E Buchman | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2019-10-31 |
| 1558911412 | Anne Renee Adelson | Physician Assistant | 6777 W Maple Rd, West Bloomfield, MI 48322-3031 | 2019-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483492 | Life Saver Home Health, LLC | Home Health | 6436 Silverbrooke, West Bloomfield, MI 48322 | 2020-10-06 |
| 1316557374 | Gabrielle Benaderet | Speech-Language Pathologist | 6548 Heritage, West Bloomfield, MI 48322 | 2020-08-05 |
| 1437774197 | Madeline Gail Tenenbaum | Social Worker | 6800 W. Maple Rd., West Bloomfield, MI 48322 | 2020-06-09 |
| 1639705676 | Stephanie Cole | Social Worker | 5749 Crossgate, West Bloomfield, MI 48322 | 2020-03-22 |
| 1407409709 | Laura Elizabeth Large | Social Worker | Couseling Associates, Inc., 6960 Orchard Lake Rd. Ste. 100, W. Bloomfield, MI 48322 | 2019-07-17 |
| 1144796533 | Jaleesa Davis | Home Health Aide | 6436 Silverbrook W, West Bloomfield, MI 48322 | 2018-10-23 |
| 1912484411 | Mjl Therapy Pllc | Clinic/Center | 5745 West Maple Road Suite 213, West Bloomfield, MI 48322 | 2018-07-26 |
| 1396247847 | Martha Gomez-pedraza | Physical Therapist | 6200 Orchard Lake Rd - Suite Ll9, West Bloomfield, MI 48322 | 2018-03-01 |
| 1659872174 | Jennifer Marie O'connor | Physical Therapist | Beaumont Medical Center West Bloomfield, 6900 Orchard Lake Rd., Suite Ll09, West Bloomfield, MI 48322 | 2018-02-21 |
| 1851890834 | Naomi Marie Lang | Physical Therapy Assistant | 6535 Drake Rd. West, Bloomfield Township, MI 48322 | 2018-02-06 |
| Find all providers in zip 48322 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073025334 | Robert J Stachler Md PC | Otolaryngology | 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 | 2017-10-26 |
| 1174905822 | Scott Jacob Schwartz | Otolaryngology | 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 | 2015-06-18 |
| 1134169014 | Robert John Stachler | Otolaryngology | 33200 W 14 Mile Rd Ste 240, West Bloomfield, MI 48322-3586 | 2006-06-07 |
| 1962673939 | Melissa Mcbrien, M.d., P.l.l.c. | Otolaryngology | 6900 Orchard Lake Rd, Suite 314, West Bloomfield, MI 48322-3405 | 2008-03-18 |
| 1043495864 | Esmael H Amjad Md PC | Otolaryngology | 33200 W 14 Mile Rd, Ste 230, West Bloomfield, MI 48322-3563 | 2007-12-31 |
| 1598828113 | Vigen Darian | Otolaryngology | Henry Ford Health System, 6777 West Maple Road, West Bloomfield, MI 48323 | 2006-12-18 |
| 1588730956 | Vanessa G. Schweitzer | Otolaryngology | Henry Ford Health System, 6777 West Maple Road, West Bloomfield, MI 48323 | 2006-11-28 |
| 1336173400 | Louis L Sobol | Otolaryngology | 6900 Orchard Lake Rd, Ste 314, West Bloomfield, MI 48322 | 2006-07-11 |
| 1861474009 | Mary Melissa Mcbrien | Otolaryngology | 6900 Orchard Lake Rd, Suite 314, West Bloomfield, MI 48322-3405 | 2005-11-15 |
| 1578554424 | Peggyann Nowak | Otolaryngology | 6900 Orchard Lake Rd, Ste 314, West Bloomfield, MI 48322 | 2005-10-31 |
| Find all providers in WEST BLOOMFIELD | ||||
| City | WEST BLOOMFIELD |
| Zip Code | 48322 |
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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.