Mary E Petty-dudley (NPI# 1902853252, PAC ID# 0648282558) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1902853252 |
| PAC ID by PECOS | 0648282558 |
| Professional Enrollment ID | I20060614000244 |
| Full Name | Mary E Petty-dudley |
| Organization Legal Name | SOUTHGATE MEDICAL GROUP, PLLC |
| Address |
3 Heritage Dr Suite 1 Southgate MI 48195-3000 |
| Phone Number | 7342833222 |
| Gender | F |
| Credential | MD |
| Medical School | WEST COAST CHIROPRACTIC COLLEGE |
| Graduation Year | 1991 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | INFECTIOUS DISEASE |
| Group Practice PAC ID | 1456307560 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230024 | SINAI-GRACE HOSPITAL |
| 230104 | HARPER UNIVERSITY HOSPITAL |
| 230020 | BEAUMONT HOSPITAL - DEARBORN |
| Address | Phone | Organization |
|---|---|---|
| 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 | 7342833222 | SOUTHGATE MEDICAL GROUP, PLLC |
| Organization Legal Name | SOUTHGATE MEDICAL GROUP, PLLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J Neshewat | Internal Medicine | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Robyn Rachesky Torof | General Practice | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Steven Lis | Family Practice | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Street Address |
3 HERITAGE DR SUITE 1 |
| City | SOUTHGATE |
| State | MI |
| Zip | 48195-3000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Uzma Zafar | Infectious Disease | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 | |
| Michael J Neshewat | Internal Medicine | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Robyn Rachesky Torof | General Practice | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Kashif M Chaudhry | Internal Medicine | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 | |
| Steven Lis | Family Practice | Southgate Medical Group, Pllc | 3 Heritage Dr, Suite 1, Southgate, MI 48195-3000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Baghdoian | Orthopedic Surgery | 13479 Northline Rd, Southgate, MI 48195-1064 | |
| Kate Schmoekel | Physical Therapy | Orthopedic Associates, P.C. | 13479 Northline Rd, Southgate, MI 48195-1064 |
| Ramalingeswara Yalamanchi | Internal Medicine | 13300 Northline Rd, Southgate, MI 48195-1065 | |
| Rajasingh Johnson | Physical Therapy | 13245 Northline Rd, Southgate, MI 48195-1070 | |
| Howard B Shore | Chiropractic | 13560 Northline Rd, Southgate, MI 48195-1080 | |
| Lisa A Marlow | Qualified Audiologist | Sheila M Ray Md PC | 13136 Fort St, Southgate, MI 48195-1102 |
| Sheila M Ray | Otolaryngology | Sheila M Ray Md PC | 13136 Fort St, Southgate, MI 48195-1102 |
| Ali Saad | Allergy/immunology | 12811 Northline Rd, Southgate, MI 48195-1109 | |
| Aaron L Scheinker | Optometry | 13350 Fort St, Southgate, MI 48195-1137 | |
| Amal M Abdul Hussein | Family Medicine | Southgate Medical Center Pllc | 13460 Fort St, Southgate, MI 48195-1138 |
| Find all physicians in zip 48195 | |||
| City | SOUTHGATE |
| Zip Code | 48195 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SOUTHGATE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Mary E Petty-dudley.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.