Latisha Monique Malcom (NPI# 1114999430, PAC ID# 2466427547) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1114999430 |
| PAC ID by PECOS | 2466427547 |
| Professional Enrollment ID | I20040901000249 |
| Full Name | Latisha Monique Malcom |
| Organization Legal Name | WESTERN WAYNE FAMILY HEALTH CENTERS |
| Address |
2700 Hamlin Blvd Inkster MI 48141-2206 |
| Phone Number | 3135615100 |
| Gender | F |
| Credential | MD |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 4082617998 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230244 | GARDEN CITY HOSPITAL |
| 230142 | BEAUMONT HOSPITAL - WAYNE |
| 230020 | BEAUMONT HOSPITAL - DEARBORN |
| Address | Phone | Organization |
|---|---|---|
| 2700 Hamlin Blvd, Inkster, MI 48141-2206 | 3135615100 | WESTERN WAYNE FAMILY HEALTH CENTERS |
| Organization Legal Name | WESTERN WAYNE FAMILY HEALTH CENTERS |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter Scuccimarri | Family Medicine | Western Wayne Family Health Centers | 25650 Outer Dr, Lincoln Park, MI 48146-2096 |
| Jason D Wilkinson | Psychologist, Clinical | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Patricia A Thomas | Clinical Social Worker | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Cheryl Lee Ivie | Nurse Practitioner | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Laura Sheri Kremer | Nurse Practitioner | Western Wayne Family Health Centers | 26650 Eureka Rd, C1, Taylor, MI 48180-4835 |
| Alireza Amirsadri | Psychiatry | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Antoinette Byrd Carr | Obstetrics/gynecology | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Felicia E Randolph | Internal Medicine | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Marie Shoulders-williams | Nurse Practitioner | Western Wayne Family Health Centers | 25650 Outer Dr, Lincoln Park, MI 48146-2096 |
| Gillian Margaret Clifford | Nurse Practitioner | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Street Address |
2700 HAMLIN BLVD |
| City | INKSTER |
| State | MI |
| Zip | 48141-2206 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason D Wilkinson | Psychologist, Clinical | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Patricia A Thomas | Clinical Social Worker | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Cheryl Lee Ivie | Nurse Practitioner | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Alireza Amirsadri | Psychiatry | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Antoinette Byrd Carr | Obstetrics/gynecology | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Felicia E Randolph | Internal Medicine | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Gillian Margaret Clifford | Nurse Practitioner | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Latoya S Richardson | Nurse Practitioner | Western Wayne Family Health Centers | 2700 Hamlin Blvd, Inkster, MI 48141-2206 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachael Ann Kasperowicz | Family Medicine | Osh-mi Physicians Group PC | 27155 Cherry Hill Rd, Inkster, MI 48141-1204 |
| Leila Abbas | Nurse Practitioner | Osh-mi Physicians Group PC | 27155 Cherry Hill Rd, Inkster, MI 48141-1204 |
| Sheila M Blanding | Nurse Practitioner | Osh-mi Physicians Group PC | 27155 Cherry Hill Rd, Inkster, MI 48141-1204 |
| Danielle F Daniel | Internal Medicine | Osh-mi Physicians Group PC | 27155 Cherry Hill Rd, Inkster, MI 48141-1204 |
| Nilufa Akhter | Family Medicine | Osh-mi Physicians Group PC | 27155 Cherry Hill Rd, Inkster, MI 48141-1204 |
| Gary L Thomas | Clinical Social Worker | Next Level Up Health and Wellness Inc | 27436 Avondale St, Inkster, MI 48141-1787 |
| Claudia Cacciato | Clinical Social Worker | Hegira Health Inc | 1403 Inkster Rd, Inkster, MI 48141-1831 |
| Edward A Lamsen | Psychiatry | Hegira Health Inc | 1403 Inkster Rd, Inkster, MI 48141-1831 |
| Alfred C Spitzer | Clinical Social Worker | Hegira Health Inc | 1403 Inkster Rd, Inkster, MI 48141-1831 |
| Ingrid L Blair | Nurse Practitioner | Hegira Health Inc | 1403 Inkster Rd, Inkster, MI 48141-1831 |
| Find all physicians in zip 48141 | |||
| City | INKSTER |
| Zip Code | 48141 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | INKSTER + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Latisha Monique Malcom.
| 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.