SAILAJA DATLA MD PLC (NPI# 1881928455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881928455 |
| Entity Type | Organization |
| Organization Name | SAILAJA DATLA MD PLC |
| Practice Address |
21519 Harper Ave Ste 108 Saint Clair Shores MI 48080-2220 |
| Practice Telephone | 5864453706 |
| Mailing Telephone | 5864453706 |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |
| Authorized Official Name | SAILAJA DATLA (OWNER) |
| Authorized Official Telephone | 5864453706 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | SD070545 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4354525 | 05 | |
| BCBS | 1105010262 | 01 |
| Street Address |
21519 HARPER AVE STE 108 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-2220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1316104094 | Shores Medical Associates Pllc | Internal Medicine | 25200 Little Mack Ave, Saint Clair Shores, MI 48081-2116 | 2008-05-20 |
| 1235251042 | Robbie H Taha | Internal Medicine | 25631 Little Mack Ave Ste 205, Saint Clair Shores, MI 48081-2108 | 2007-04-04 |
| 1356499800 | George S Afram | Internal Medicine | 29275 Harper Ave, Saint Clair Shores, MI 48081-1248 | 2007-01-08 |
| 1346397411 | Paavan P Railan | Internal Medicine | 26901 Harper Ave, Saint Clair Shores, MI 48081-1971 | 2007-01-04 |
| 1871688549 | Denise M Jabbour | Internal Medicine | 23715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1181 | 2006-10-04 |
| 1831201821 | Eastside Internal Medicine PC | Internal Medicine | 28315 Harper Ave, Saint Clair Shores, MI 48081-1687 | 2006-08-31 |
| 1154434975 | Sailaja Datla | Internal Medicine | 24800 Harper Ave Ste 1, Saint Clair Shores, MI 48080-1292 | 2006-08-16 |
| 1902835168 | Vincent Colina Maribao | Internal Medicine | 29167 Jefferson Ave Ste 100, Saint Clair Shores, MI 48081-1331 | 2006-07-01 |
| 1063486736 | Demetrios Mermiges | Internal Medicine | 19611 E 8 Mile Rd, Saint Clair Shores, MI 48080-1655 | 2006-02-17 |
| 1376523233 | Maya Ashkenazi | Internal Medicine | 23003 Greater Mack Ave, Saint Clair Shores, MI 48080-1965 | 2006-01-18 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
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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.