Iha Ooma Primary Llc | |
43097 Woodward Ave Ste 204 Bloomfield Township MI 48302-5043 | |
(248) 836-0040 | |
(248) 836-0042 |
Full Name | Iha Ooma Primary Llc |
---|---|
Speciality | Family Medicine |
Location | 43097 Woodward Ave Ste 204, Bloomfield Township, Michigan |
Authorized Official Name and Position | Cynthia Elliott (PRESIDENT & CHIEF OPERATING OFFICER) |
Authorized Official Contact | 7347476766 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Iha Ooma Primary Llc 24 Frank Lloyd Wright Dr Ste J2000 Ann Arbor MI 48105-9484 Ph: () - | Iha Ooma Primary Llc 43097 Woodward Ave Ste 204 Bloomfield Township MI 48302-5043 Ph: (248) 836-0040 |
NPI Number | 1245815984 |
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Provider Enumeration Date | 03/15/2021 |
Last Update Date | 03/15/2021 |
Medicare PECOS PAC ID | 7012316664 |
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Medicare Enrollment ID | O20210601002563 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245815984 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Paunel Grivej |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215986682 PECOS PAC ID: 1456252915 Enrollment ID: I20040116000848 |
Provider Name | Laura Elizabeth Sychta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548571862 PECOS PAC ID: 6204801178 Enrollment ID: I20040902000083 |
Provider Name | Jacky Duong |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1780693671 PECOS PAC ID: 3375510159 Enrollment ID: I20040913000025 |
Provider Name | Robert N Israel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083688261 PECOS PAC ID: 5991749111 Enrollment ID: I20050617000313 |
Provider Name | Hadeel N Razook |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336119437 PECOS PAC ID: 4486676608 Enrollment ID: I20051230000394 |
Provider Name | Tejal Shah Joseph |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013995125 PECOS PAC ID: 8426062001 Enrollment ID: I20060202000878 |
Provider Name | Benjamin J Diaczok |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1760480834 PECOS PAC ID: 1355350463 Enrollment ID: I20060419000023 |
Provider Name | Nashwan Y Yousif |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124042288 PECOS PAC ID: 9739183278 Enrollment ID: I20060914000182 |
Provider Name | Brenda J Pope |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568519593 PECOS PAC ID: 4688776388 Enrollment ID: I20070227000470 |
Provider Name | Geetha Krishnamoorthy |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1790723625 PECOS PAC ID: 5193828937 Enrollment ID: I20070315000061 |
Provider Name | Leslie A Caren |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1649288960 PECOS PAC ID: 4688758717 Enrollment ID: I20080227000426 |
Provider Name | Michael Krivitsky |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710986955 PECOS PAC ID: 4486738234 Enrollment ID: I20080303000681 |
Provider Name | Timothy G Dickson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366448896 PECOS PAC ID: 4486739133 Enrollment ID: I20080305000687 |
Provider Name | Walter Culver |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346240918 PECOS PAC ID: 7810072568 Enrollment ID: I20080305000712 |
Provider Name | Amy J Mccarthy |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972509404 PECOS PAC ID: 5890873186 Enrollment ID: I20080428000453 |
Provider Name | Bhupendranath G Patel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932143971 PECOS PAC ID: 6204906662 Enrollment ID: I20080528000618 |
Provider Name | Cecilia Cristina Cosma |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992973721 PECOS PAC ID: 5597827469 Enrollment ID: I20081231000255 |
Provider Name | Rhonda A Gumma |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487868600 PECOS PAC ID: 1254470693 Enrollment ID: I20091125000148 |
Provider Name | Christine R Schloesser |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982720066 PECOS PAC ID: 6103963293 Enrollment ID: I20100929001096 |
Provider Name | Tatyanna R Coleman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427178250 PECOS PAC ID: 2163745498 Enrollment ID: I20141217002635 |
Provider Name | Victoria J Torgler |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225304272 PECOS PAC ID: 6002066966 Enrollment ID: I20150709000884 |
Provider Name | Tassia Pfefferkorn |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1467716514 PECOS PAC ID: 9638486749 Enrollment ID: I20150922000305 |
Provider Name | Tania L Oliver |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679942478 PECOS PAC ID: 8820390842 Enrollment ID: I20160108000032 |
Provider Name | Katie R Zechar |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306070172 PECOS PAC ID: 4587812847 Enrollment ID: I20170718002064 |
Provider Name | Pritha Chitagi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1811316813 PECOS PAC ID: 4385940063 Enrollment ID: I20170726002677 |
Provider Name | Daniel Meram |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215354493 PECOS PAC ID: 5597085787 Enrollment ID: I20171013002879 |
Provider Name | Elyse Marie Hewitt |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083006407 PECOS PAC ID: 1850693565 Enrollment ID: I20181105001398 |
Provider Name | David Mcnaughton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568843142 PECOS PAC ID: 4183938160 Enrollment ID: I20181119003370 |
Provider Name | Courtney Paladino |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023453453 PECOS PAC ID: 7618207895 Enrollment ID: I20191002000121 |
Provider Name | Bashar Maskoni |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942733944 PECOS PAC ID: 2264704428 Enrollment ID: I20200702002201 |
Provider Name | Kathryn A Rice |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1245684190 PECOS PAC ID: 2961794490 Enrollment ID: I20210129002128 |
Provider Name | Nora Hana Dagher |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215420377 PECOS PAC ID: 7911309067 Enrollment ID: I20210712002620 |
Provider Name | Shibani Tipnis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497325476 PECOS PAC ID: 3375946296 Enrollment ID: I20210729000605 |
Provider Name | Rucha Modak |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1659042695 PECOS PAC ID: 3274931332 Enrollment ID: I20211005001108 |
Provider Name | Eleni M. Scott |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841784022 PECOS PAC ID: 6204182348 Enrollment ID: I20211005002022 |
Provider Name | Jessica Senopole |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942807441 PECOS PAC ID: 6103216411 Enrollment ID: I20211130002743 |
Provider Name | Anna Pierzchala |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265728802 PECOS PAC ID: 1153645437 Enrollment ID: I20211207001912 |
Provider Name | Daniel Warden |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710428016 PECOS PAC ID: 7113251752 Enrollment ID: I20220524002360 |
Provider Name | Samantha Hight |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1114663317 PECOS PAC ID: 2860879244 Enrollment ID: I20220525000287 |
Provider Name | Bradford J Woelke |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184121824 PECOS PAC ID: 5092111385 Enrollment ID: I20220615000784 |
Provider Name | Michael Allen Scarchilli |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760944037 PECOS PAC ID: 4981937968 Enrollment ID: I20220720000671 |
Provider Name | Kevin Do |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750777066 PECOS PAC ID: 9436405586 Enrollment ID: I20221130002254 |
Provider Name | Derek Foster |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508493982 PECOS PAC ID: 2769804582 Enrollment ID: I20230601001964 |
Provider Name | Vincent Hannosh |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861028821 PECOS PAC ID: 2466875257 Enrollment ID: I20230613002183 |
Provider Name | Dalia Alhusein |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558984468 PECOS PAC ID: 7416378328 Enrollment ID: I20230906003884 |
Mudassir Daimee Md , Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5248 Provincial Dr, Bloomfield Township, MI 48302 Phone: 248-302-9147 |