KAYLAN PUSTOVER (NPI# 1871901918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871901918 |
Entity Type | Individual |
Full Name | KAYLAN PUSTOVER |
Practice Address |
5333 Mcauley Dr Suite 5003 Ypsilanti MI 48197-1014 |
Practice Telephone | 7347123376 |
Enumeration Date | 2014-07-31 |
Last Update Date | 2019-05-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 293128 | NY | Allopathic & Osteopathic Physicians |
N | 207N00000X | Dermatology | 5101021933 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | NY LICENSE | 293128 | 01 |
Street Address |
5333 MCAULEY DR SUITE 5003 |
City | YPSILANTI |
State | MI |
Zip Code | 48197-1014 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740285378 | Thomas A Weimert | Otolaryngology | 5333 Mcauley Dr, Rm 2017, Ypsilanti, MI 48197-1096 | 2005-06-20 |
1780172809 | Meena Sahu | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Ypsilanti, MI 48197-1014 | 2018-04-24 |
1568996940 | Cydney Siggins | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 2110, Ypsilanti, MI 48197-1014 | 2017-04-12 |
1205369725 | Kenneth John Buchanan | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 4001, Ypsilanti, MI 48197-1014 | 2017-04-11 |
1518491059 | Mahwish Hafeez | Internal Medicine | 5333 Mcauley Dr, Suite 4001, Ypsilanti, MI 48197-1014 | 2017-04-11 |
1124551791 | Emily Welker | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 2115, Ypsilanti, MI 48197-1014 | 2017-04-10 |
1366975195 | Patrick D Suggs | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 2115, Ypsilanti, MI 48197-1014 | 2017-04-08 |
1528591427 | Elizabeth Anne Henderson | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 4001, Ypsilanti, MI 48197-1014 | 2017-04-06 |
1043742448 | Emily Eton | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 4001, Ypsilanti, MI 48197-1014 | 2017-04-03 |
1740711126 | Kelsey Behan | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr, Suite 2110, Ypsilanti, MI 48197-1014 | 2017-03-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
Find all providers in zip 48197 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
1679955041 | Luke D Killpack | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2015-06-22 |
1811345093 | Molly Buckland | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2016-05-29 |
1740638949 | Ashley Reader | Dermatology | 5333 Mcauley Drive, Suite 5003, Ypsilanti, MI 48197-1014 | 2016-05-27 |
1235517418 | Iha Health Services Corporation | Dermatology | 5333 Mcauley Dr, 5th Floor, Suite 5003, Ypsilanti, MI 48197-1014 | 2015-05-08 |
1679968150 | Michael Dewall | Dermatology | 5301 E Huron River Dr, Ypsilanti, MI 48197-1051 | 2015-04-01 |
1861818676 | Jennifer Vermeesch | Dermatology | 5333 Mcauley Dr, Suite 5003, Ypsilanti, MI 48197-1014 | 2014-03-17 |
1164858221 | Iha Health Services Corporation | Dermatology | 4990 W Clark Rd, Ste 400, Ypsilanti, MI 48197-1149 | 2013-09-20 |
1285898155 | Hyuk C Cha | Dermatology | 4990 W Clark Rd, Ste 400, Ypsilanti, MI 48197-1149 | 2008-07-10 |
1609995125 | St Joseph Mercy Hospital | Dermatology | 5301 E Huron River Dr, Pathology Department, Ypsilanti, MI 48197-1051 | 2007-03-28 |
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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.