DR. SHAUN CARDOZO (NPI# 1952638272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952638272 |
| Entity Type | Individual |
| Full Name | DR. SHAUN CARDOZO |
| Credential | MD |
| Practice Address |
4160 John R Suite 804 Detroit MI 48201-2014 |
| Mailing Address |
1560 E. Maple Rd. Suite 400-credentialing Troy MI 48083 |
| Practice Telephone | 3137454525 |
| Practice Fax Number | 3139937770 |
| Mailing Telephone | 3137454525 |
| Mailing Fax Number | 3139937770 |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2016-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301093033 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301093033 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4160 JOHN R SUITE 804 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629070271 | Lisa M Flynn | Surgery | 4160 John R, Suite 615, Detroit, MI 48201-2020 | 2005-08-12 |
| 1215286976 | Danna Maria Brock | Nurse Practitioner | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2012-09-09 |
| 1346578127 | Ilyes Benchaala | Internal Medicine | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2009-12-07 |
| 1609000819 | Delorean Q Griffin | Plastic Surgery | 4160 John R, 400, Detroit, MI 48202-2819 | 2009-05-04 |
| 1427228345 | Neather Odessa Libutsi | Social Worker | 4160 John R, Ste 804 Harper Professional Bldg, Detroit, MI 48201 | 2008-03-06 |
| 1871661348 | Ramarao Kaza Md PC | Urology | 4160 John R, Suite 809, Detroit, MI 48201 | 2006-12-01 |
| 1881762334 | Yahya M. Osman-malik | Internal Medicine | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2006-12-01 |
| 1659448751 | James J Glazier Md PC | Internal Medicine | 4160 John R, Suite 525, Detroit, MI 48201 | 2006-11-30 |
| 1366534232 | Shivkumar Prabhu, M.d., P.C. | Internal Medicine | 4160 John R, Suite 702, Detroit, MI 48201 | 2006-09-29 |
| 1346343449 | Xiaoping Huang | Internal Medicine | 4160 John R, Suite 729, Detroit, MI 48201 | 2006-09-06 |
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| 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 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1831539469 | Bayoan Manuel Ramos-parra | Internal Medicine | 311 Mack Ave Ste 21025, Detroit, MI 48201-2466 | 2013-06-27 |
| 1972796373 | Mark K. Lahiri | Internal Medicine | 2799 W Grand Blvd., Detroit, MI 48202 | 2007-08-20 |
| 1619181427 | Aiden Abidov | Internal Medicine | 4160 John R St Ste 804, Detroit, MI 48201-2014 | 2007-05-10 |
| 1174740229 | Benjamin A Burroughs | Internal Medicine | 2799 W. Grand Blvd, K-14, Henry Ford Cardiac Surgery Pofessional Building, Detroit, MI 48202 | 2007-04-19 |
| 1225151061 | Dee Dee Wang | Internal Medicine | 2799 W Grand Blvd # K-14, Detroit, MI 48202-2608 | 2007-04-09 |
| 1831267376 | Arif Husain Hakim | Internal Medicine | 14500 W Mcnichols Rd, Detroit, MI 48235-3904 | 2006-12-01 |
| 1528145679 | Zeia Casab Rueda | Internal Medicine | 5662 W Vernor Hwy, Detroit, MI 48209-2158 | 2006-11-01 |
| 1841398880 | Narsimha Reddy Gottam | Internal Medicine | 7633 E Jefferson Ave., Suite #360, Detroit, MI 48214-3732 | 2006-09-21 |
| 1033221056 | Khaled M Sleik | Internal Medicine | 311 Mack Ave Ste 2101, Detroit, MI 48201-2466 | 2006-08-31 |
| 1992817076 | Pritpal Singh Puri | Internal Medicine | Harper Hospital 3990john R, C/o Medical Affairs, Detroit, MI 48201-2403 | 2006-08-31 |
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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.