BOSTON MEDICAL GROUP, P.C. (NPI# 1912324211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912324211 |
| Entity Type | Organization |
| Organization Name | BOSTON MEDICAL GROUP, P.C. |
| Practice Address |
24901 Northwestern Hwy. Suite 615 Southfield MI 48075 |
| Practice Telephone | 2483569330 |
| Practice Fax Number | 2483559725 |
| Mailing Telephone | 2483569330 |
| Mailing Fax Number | 2483559725 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |
| Authorized Official Name | MS. MARIANNE C. LABARBERA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7189814070 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174940480 | Boston Medical Group, P.C. | Urology | 30 N Michigan Ave, Suite 706, Chicago, IL 60602 | 2014-03-25 |
| Street Address |
24901 NORTHWESTERN HWY. SUITE 615 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851592489 | Melvin L. Hollowell, M.d., F.a.c.s. | Urology | 20905 Greenfield Rd Ste 507, Southfield, MI 48075-5351 | 2007-05-30 |
| 1538334768 | Marc S Arnkoff M D and Gregory L. Weigler D O P C | Urology | 26400 W 12 Mile Rd, Suite 70, Southfield, MI 48034-1700 | 2008-04-29 |
| 1083887822 | George A Lightbourn Md PC | Urology | 29600 Northwestern Hwy, Suite 104, Southfield, MI 48034-1016 | 2008-04-11 |
| 1578750006 | Tewodros Fesseha, M.d., P.C. | Urology | 20905 Greenfield Rd, Suite 407, Southfield, MI 48075-5360 | 2007-09-28 |
| 1063625382 | Preferred Urology Consultants, P.c | Urology | 29201 Telegraph Rd, Suite 460, Southfield, MI 48034-1331 | 2007-05-07 |
| 1558411512 | Michigan Urological Institute | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2007-01-11 |
| 1639241441 | Melvin Laverne Hollowell | Urology | 20905 Greenfield, #507, Southfield, MI 48075 | 2006-11-15 |
| 1285643148 | George A Lightbourn | Urology | 29600 Northwestern Hwy, Suite 104, Southfield, MI 48034-1016 | 2006-08-07 |
| 1528011830 | Jeffrey Lawrence O'connor | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2006-05-18 |
| 1336192400 | James Bernard Smith Jr. | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2006-05-18 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.