| Great Lakes Medicine, Plc | |
|
50505 Schoenherr Rd Ste 340 Shelby Township MI 48315-3140 | |
| (586) 731-8400 | |
| (586) 731-8406 |
| Full Name | Great Lakes Medicine, Plc |
|---|---|
| Speciality | Hospitalist |
| Location | 50505 Schoenherr Rd, Shelby Township, Michigan |
| Authorized Official Name and Position | Prashant S Patel (PARTNER) |
| Authorized Official Contact | 5867318400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Medicine, Plc 1746 Momentum Pl Chicago IL 60689-5317 Ph: (586) 731-8400 | Great Lakes Medicine, Plc 50505 Schoenherr Rd Ste 340 Shelby Township MI 48315-3140 Ph: (586) 731-8400 |
| NPI Number | 1740210517 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 11/05/2012 |
| Medicare PECOS PAC ID | 4880613637 |
|---|---|
| Medicare Enrollment ID | O20051122000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740210517 | NPI | - | NPPES |
| DE1755 | Other | MI | RR MEDICARE |
| 0E03034 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 207R00000X (Michigan) | Secondary |
| 208M00000X | Hospitalist | 208M00000X (Michigan) | Primary |
| Provider Name | Malaz Alatassi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023069770 PECOS PAC ID: 3678467578 Enrollment ID: I20040211000826 |
| Provider Name | Michelle M Trudeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689641441 PECOS PAC ID: 7315935483 Enrollment ID: I20040505001539 |
| Provider Name | Seth Byron Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144214008 PECOS PAC ID: 8527058817 Enrollment ID: I20040518000200 |
| Provider Name | Louise Osbourn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376597138 PECOS PAC ID: 4385601806 Enrollment ID: I20041216000522 |
| Provider Name | Prashant S Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689668543 PECOS PAC ID: 2961421714 Enrollment ID: I20051128000129 |
| Provider Name | Harpal Jande |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215932892 PECOS PAC ID: 8729095385 Enrollment ID: I20060307000804 |
| Provider Name | Wahed Ishaqsei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063423176 PECOS PAC ID: 8527068360 Enrollment ID: I20070102000139 |
| Provider Name | Doris V Coca Soto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093882631 PECOS PAC ID: 5890898811 Enrollment ID: I20070313000286 |
| Provider Name | Janaina M Zilli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366544058 PECOS PAC ID: 6103927785 Enrollment ID: I20070726000376 |
| Provider Name | Betsy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215264999 PECOS PAC ID: 4385785435 Enrollment ID: I20100111000795 |
| Provider Name | Dheeraj Thammineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710115969 PECOS PAC ID: 6406041672 Enrollment ID: I20101112001065 |
| Provider Name | Salvador Rojas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275709446 PECOS PAC ID: 5294994760 Enrollment ID: I20120302000453 |
| Provider Name | Wendy L Carriveau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992062251 PECOS PAC ID: 4880843119 Enrollment ID: I20121002000629 |
| Provider Name | Mohammad F Sunbulli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841571544 PECOS PAC ID: 6507011525 Enrollment ID: I20130225000022 |
| Provider Name | Manuela A Della Torre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417384868 PECOS PAC ID: 9133358948 Enrollment ID: I20140127000757 |
| Provider Name | Hardev Kaur Shergill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437583465 PECOS PAC ID: 9032348545 Enrollment ID: I20140203001480 |
| Provider Name | Jennifer Anne Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538508593 PECOS PAC ID: 0749412351 Enrollment ID: I20140414002069 |
| Provider Name | Paula Carla Leferman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861804155 PECOS PAC ID: 0941424212 Enrollment ID: I20140609000389 |
| Provider Name | Shawkat Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558657551 PECOS PAC ID: 6709001787 Enrollment ID: I20140707002117 |
| Provider Name | Paul Thomas Pulice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932463528 PECOS PAC ID: 0941529770 Enrollment ID: I20150429001414 |
| Provider Name | Elizabeth Marie Chapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467892257 PECOS PAC ID: 3870814148 Enrollment ID: I20150611002483 |
| Provider Name | Liz Mary Wilson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184980690 PECOS PAC ID: 1850524638 Enrollment ID: I20150622001873 |
| Provider Name | Amir Sankari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255771218 PECOS PAC ID: 4587953914 Enrollment ID: I20160525000612 |
| Provider Name | Bradley T. Shobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245670686 PECOS PAC ID: 6204155997 Enrollment ID: I20160609001898 |
| Provider Name | Anthony Shen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619218336 PECOS PAC ID: 2163655036 Enrollment ID: I20160621001546 |
| Provider Name | Russell A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013455922 PECOS PAC ID: 1759665292 Enrollment ID: I20170301002297 |
| Provider Name | Tara Deryavoush |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851718092 PECOS PAC ID: 3577783232 Enrollment ID: I20170522000933 |
| Provider Name | Nicole E Graessle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497281935 PECOS PAC ID: 7315214772 Enrollment ID: I20170606002549 |
| Provider Name | Diane Palm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376079426 PECOS PAC ID: 9234496977 Enrollment ID: I20171205001034 |
| Provider Name | Bethany J Gadd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760993828 PECOS PAC ID: 4284994104 Enrollment ID: I20180214000079 |
| Provider Name | Alicja Salman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508252156 PECOS PAC ID: 8527360528 Enrollment ID: I20180524001454 |
| Provider Name | Sima Salahie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053450460 PECOS PAC ID: 6507961430 Enrollment ID: I20180524001604 |
| Provider Name | Waseem Obeid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457733297 PECOS PAC ID: 2769773456 Enrollment ID: I20180724003533 |
| Provider Name | Andrew Fletcher Chisholm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306325048 PECOS PAC ID: 5991055766 Enrollment ID: I20180829002774 |
| Provider Name | Brian Tyson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740664499 PECOS PAC ID: 1658663844 Enrollment ID: I20181004003044 |
| Provider Name | Raya Kutaimy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821484122 PECOS PAC ID: 6103123047 Enrollment ID: I20181120003271 |
| Provider Name | Jonnika Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518440775 PECOS PAC ID: 7012252596 Enrollment ID: I20190103000882 |
| Provider Name | Varun Sai Yelamanchili |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396165080 PECOS PAC ID: 4688965866 Enrollment ID: I20190613003324 |
| Provider Name | Zahraa Karoofa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801246012 PECOS PAC ID: 6204164999 Enrollment ID: I20190819003497 |
| Provider Name | Thomas Deverne Bussineau |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992155055 PECOS PAC ID: 7517250210 Enrollment ID: I20191109000132 |
| Provider Name | Andrew M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437710639 PECOS PAC ID: 0547692931 Enrollment ID: I20191125001222 |
| Provider Name | Carly Renee Knudsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366092769 PECOS PAC ID: 0042643215 Enrollment ID: I20191202000187 |
| Provider Name | Matthew Garrity |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457883985 PECOS PAC ID: 4183990062 Enrollment ID: I20200408001640 |
| Provider Name | Janelle Kyla Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053979310 PECOS PAC ID: 8123352259 Enrollment ID: I20210401001476 |
| Provider Name | Ahmed Zaki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548750730 PECOS PAC ID: 8820407265 Enrollment ID: I20210514000704 |
| Provider Name | Ronak Rakesh Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679069538 PECOS PAC ID: 4486903424 Enrollment ID: I20210514001155 |
| Provider Name | Nabih Hammoud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568968535 PECOS PAC ID: 8820344799 Enrollment ID: I20210514001490 |
| Provider Name | Laith N Al-janabi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053817239 PECOS PAC ID: 9537418132 Enrollment ID: I20210520001067 |
| Provider Name | Gurinder Pal Gakhal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972009967 PECOS PAC ID: 1850647710 Enrollment ID: I20210603001093 |
| Provider Name | Karen Ann Pfeil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699341925 PECOS PAC ID: 7911306394 Enrollment ID: I20210604002684 |
| Provider Name | Akhlema Paru Haidar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063908077 PECOS PAC ID: 0749539336 Enrollment ID: I20210713000669 |
| Provider Name | Lindsey Woodbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619515053 PECOS PAC ID: 5991131583 Enrollment ID: I20211208001992 |
| Provider Name | Hassan Ali Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033631858 PECOS PAC ID: 2769739465 Enrollment ID: I20220118001233 |
| Provider Name | Neel V Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477117828 PECOS PAC ID: 6800121070 Enrollment ID: I20220520001042 |
| Provider Name | John Paul Mcroberts |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194205773 PECOS PAC ID: 6709135809 Enrollment ID: I20220714004003 |
| Provider Name | Zaid Kaloti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780171736 PECOS PAC ID: 3779839428 Enrollment ID: I20220921001210 |
| Provider Name | Sumi Alias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538875364 PECOS PAC ID: 3375916174 Enrollment ID: I20230225000338 |
| Provider Name | Suzanne Franco Heilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508458613 PECOS PAC ID: 9335395227 Enrollment ID: I20230508000690 |
| Provider Name | Rachel Marie Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306525860 PECOS PAC ID: 5991159188 Enrollment ID: I20230921001548 |
| Provider Name | Alyssa Ann Jaworski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649973538 PECOS PAC ID: 6406200187 Enrollment ID: I20230928003532 |
| Provider Name | Sydney Edinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801479738 PECOS PAC ID: 9032511795 Enrollment ID: I20231115003101 |
| Provider Name | Alexis Marie Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588376487 PECOS PAC ID: 7113370032 Enrollment ID: I20240126003498 |
Gi Medicine Shelby Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50505 Schoenherr Rd, 250, Shelby Township, MI 48315 Phone: 586-447-0700 Fax: 586-498-0707 | |
Developing Connections, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14145 Simone Dr, Shelby Township, MI 48315 Phone: 586-566-6280 Fax: 586-566-6280 | |
Revolution Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 51850 Dequindre Rd Ste 2, Shelby Township, MI 48316 Phone: 586-323-0301 | |
Stony Creek Internal Medicine Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 52915 Mound Road, Shelby Township, MI 48316 Phone: 586-992-2400 | |
Integrative Family Care, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 52915 Mound Rd, Shelby Township, MI 48316 Phone: 586-210-3200 Fax: 586-210-3300 | |
Great Lakes Geriatrics Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50505 Schoenherr Rd, Suite 340, Shelby Township, MI 48315 Phone: 586-731-8400 Fax: 586-731-8406 | |
Gi Medicine Associates Pc Stonebridge Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13350 24 Mile Rd, Suite 100, Shelby Township, MI 48315 Phone: 586-447-0700 Fax: 586-447-0795 |