PAVADEE POOWUTTIKUL (NPI# 1952582314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952582314 |
| Entity Type | Individual |
| Full Name | PAVADEE POOWUTTIKUL |
| Credential | M.D. |
| Practice Address |
3950 Beaubien - 3rd Fl Childrens Hospital of Mi Detroit MI 48201-2119 |
| Mailing Address |
4201 St. Antoine - Uhc 5d Mailbox 226 University Pediatricians Detroit MI 48201-2153 |
| Practice Telephone | 3138328550 |
| Practice Fax Number | 3139938685 |
| Mailing Telephone | 3137454405 |
| Mailing Fax Number | 3139660665 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2017-01-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 4301090387 | MI | Allopathic & Osteopathic Physicians |
| Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
4301090387 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
3950 BEAUBIEN - 3RD FL CHILDRENS HOSPITAL OF MI |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548207541 | Elizabeth Ann Secord | Pediatrics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2006-05-31 |
| 1194168948 | Doris Rafic Taha | Pediatrics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2013-04-11 |
| 1295072205 | Ulyssa Hancock | Nurse Practitioner | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2013-01-10 |
| 1275887655 | Christina Marie Durkin | Nurse Practitioner | 3950 Beaubien - 3rd Fl, Childrens Hospital of Mi, Detroit, MI 48201-2120 | 2012-11-06 |
| 1568715076 | Michael Scott Bawks | Nurse Practitioner | 3950 Beaubien - 3rd Fl, Childrens Hospital of Mi, Detroit, MI 48201-2120 | 2012-10-22 |
| 1518157510 | Robert L Conway | Medical Genetics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2007-07-26 |
| 1326249145 | Divya Seth | Pediatrics | 3950 Beaubien - 3rd Fl, Childrens Hospital of Mi, Detroit, MI 48201-2119 | 2007-05-30 |
| 1275550287 | Cristina Cotronei-cascardo | Allergy & Immunology | 3950 Beaubien - 3rd Fl, Childrens Hospital of Mi, Detroit, MI 48201-2119 | 2006-07-16 |
| 1790722270 | Milind Vishnu Pansare | Pediatrics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 2080P0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Allergy/Immunology |
| A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770970246 | Jenny Huang | Pediatrics | 3950 Beaubien St, Detroit, MI 48201-2166 | 2015-04-22 |
| 1316334253 | Jeffrey Kepes | Pediatrics | 3950 Beaubien St, Detroit, MI 48201-2166 | 2015-04-17 |
| 1497823934 | Robert N. Enberg | Pediatrics | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659784718 | Amy Anna Eapen | Pediatrics | 19401 Hubbard Dr, Dearborn, MI 48126-2641 | 2014-06-06 |
| 1568671972 | Allergy & Immunology Associates of Ann Arbor, P.C. | Pediatrics | 2000 N Huron River Dr Ste 200, Ypsilanti, MI 48197-1791 | 2007-05-22 |
| 1124096367 | Carter D Brooks | Pediatrics | 1000 Oakland Dr, Kalamazoo, MI 49008-1282 | 2006-03-14 |
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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.