GAYATHRI N MANICKAM


Address: 4401 Conner St, Detroit, MI 48215-2201
Phone: 3138239800

GAYATHRI N MANICKAM (NPI# 1932319753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932319753
Entity Type Individual
Full Name GAYATHRI N MANICKAM
Credential M.D.
Practice Address 4401 Conner St
Detroit
MI 48215-2201
Mailing Address 2852 Birchdale Dr
Troy
MI 48083-6809
Practice Telephone 3138239800
Mailing Telephone 7207717792
Enumeration Date 2007-05-23
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 4301085440 MI Allopathic & Osteopathic Physicians

Office Location

Street Address 4401 CONNER ST
City DETROIT
State MI
Zip Code 48215-2201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144318924 Chantal Georges Pharmacist 4401 Conner St, Detroit, MI 48215-2201 2006-10-10
1669023057 Latoya Nicole Cosey Technician 4401 Conner St, Detroit, MI 48215-2201 2019-09-26
1912412032 Charllita Charmaine Rodgers Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-12
1770098907 Tawana Nicole Carter Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-11
1043725450 Gregory Lamont Richardson Jr. Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-07
1912412438 Marquita Jones Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-06
1962917476 Shondra Tinsley Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-06
1689189136 Candsi E-nae Mcceary Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-06
1720593254 Delisha Melvinia Montgomery Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-06
1508371063 Sandra Annette Patterson Technician 4401 Conner St, Detroit, MI 48215-2201 2017-12-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073035473 Creative Empowerment Counseling Services, LLC Community/Behavioral Health 214 Manistique, Detroit, MI 48215 2017-07-07
1801323530 Tanya Wade Social Worker 12800 E Warren, Detroit, MI 48215 2017-05-12
1992164289 Juanita Johnson Counselor 13336-40 E. Warren Ave, Detroit, MI 48215 2016-02-16
1629476379 Northeast Guidance Center Community/Behavioral Health 12800 Warren, Detroit, MI 48215 2014-12-11
1407253412 Conner Pharmacy LLC Pharmacy 4673 Conner Street, Detroit, MI 48215 2014-11-20
1053734285 Dawne Robinson Counselor 2995 Conner St, Detroit, MI 48215 2014-01-23
1790065357 Michelle Miller Counselor 2900 Conner, Bldg. A, Detroit, MI 48215 2011-08-26
1710286836 Northeast Guidance Center Community/Behavioral Health 2900 Conner St, Ste A, Detroit, MI 48215 2011-03-16
1871892992 Lisa Nicole Marszalec Counselor 12800 East Warren Ave, Detroit, MI 48215 2011-03-16
1881845014 Deborah A Caldwell Nutritionist 13340 E Warren, Detroit, MI 48215 2008-10-07
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194354811 Lorie Ann Turner Family Medicine 1728 Sheridan St, Detroit, MI 48214-2410 2020-04-04
1134787633 Behavioral Health Professionals, Inc Family Medicine 19750 Burt Road, Detroit, MI 48219 2019-05-31
1508326687 Randi Nguyen Family Medicine 22151 Moross Rd Ste 212, Detroit, MI 48236-2177 2019-03-23
1982194338 Green Cross Medical Center PC Family Medicine 18041 Greenfield Rd, Detroit, MI 48235-3120 2018-05-11
1205339306 Conant Family Care Pllc Family Medicine 3611 Carpenter St Ste 5, Detroit, MI 48212-2784 2018-03-14
1801303086 St Mary Mercy Physician Practices Family Medicine 5555 Conner St Ste 2691, Detroit, MI 48213-3812 2018-01-09
1427408376 Raquel Orlich Family Medicine 1620 Michigan Ave Ste 125, Detroit, MI 48216-1493 2016-06-21
1295181543 Ammar Charestan Family Medicine 6071 Outer Dr W, Detroit, MI 48235 2016-05-05
1629423652 Rajni Parmar Family Medicine 6001 W Outer Dr Ste 430, Detroit, MI 48235-2626 2016-04-27
1265886733 Benjamin Abraham Family Medicine One Ford Place 2e, Henry Ford Hospital, Department of Family Medicine, Detroit, MI 48202 2016-04-20
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Competitor

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City DETROIT
Zip Code 48215

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Dataset Information

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.

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