| Sparrow Clinton Hospital | |
| 
					901 S Oakland St Saint Johns MI 48879-2200  | |
| (989) 224-2338 | |
| (989) 224-2065 | 
| Full Name | Sparrow Clinton Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 901 S Oakland St, Saint Johns, Michigan | 
| Authorized Official Name and Position | Misty Gunter Russian (SUPERVISOR, PROVIDER ENROLLMENT) | 
| Authorized Official Contact | 5172536308 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sparrow Clinton Hospital 8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (517) 364-6287  | Sparrow Clinton Hospital 901 S Oakland St Saint Johns MI 48879-2200 Ph: (989) 224-2338  | 
| NPI Number | 1306893078 | 
|---|---|
| Provider Enumeration Date | 05/28/2006 | 
| Last Update Date | 03/11/2024 | 
| Medicare PECOS PAC ID | 5395658850 | 
|---|---|
| Medicare Enrollment ID | O20040301000072 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1306893078 | NPI | - | NPPES | 
| 70-0-A9-1002-0 | Other | MI | BCBS | 
| 1306893078 | Medicaid | MI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Michigan) | Primary | 
| Provider Name | Rajit Pahwa | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1689669590 PECOS PAC ID: 9032012448 Enrollment ID: I20040131000138  | 
| Provider Name | Gordon Srkalovic | 
|---|---|
| Provider Type | Practitioner - Hematology/oncology | 
| Provider Identifiers | NPI Number: 1780783282 PECOS PAC ID: 6800787946 Enrollment ID: I20040320000253  | 
| Provider Name | James Demuth | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1568568665 PECOS PAC ID: 3173414984 Enrollment ID: I20040322001552  | 
| Provider Name | Carolyn M Whatley | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1487750022 PECOS PAC ID: 9335030154 Enrollment ID: I20040322001655  | 
| Provider Name | Kalyani Vangala | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1588696918 PECOS PAC ID: 5991789711 Enrollment ID: I20040617000690  | 
| Provider Name | Kelly L Morgan | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1750474771 PECOS PAC ID: 4789663758 Enrollment ID: I20040714001445  | 
| Provider Name | Katia Rosa Nakahodo | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1811975097 PECOS PAC ID: 8820069750 Enrollment ID: I20040804000800  | 
| Provider Name | Erich E Hornbach | 
|---|---|
| Provider Type | Practitioner - Hand Surgery | 
| Provider Identifiers | NPI Number: 1629074448 PECOS PAC ID: 4486626710 Enrollment ID: I20040809000265  | 
| Provider Name | Ushasree Chamarthy | 
|---|---|
| Provider Type | Practitioner - Hematology/oncology | 
| Provider Identifiers | NPI Number: 1033215967 PECOS PAC ID: 7810953965 Enrollment ID: I20041209000663  | 
| Provider Name | Rafael A Javier | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1770536997 PECOS PAC ID: 9032021779 Enrollment ID: I20050422000910  | 
| Provider Name | Amy B Jentz | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1831204601 PECOS PAC ID: 9638198773 Enrollment ID: I20051117000292  | 
| Provider Name | Lisa M Edgerton | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1093816266 PECOS PAC ID: 0648207084 Enrollment ID: I20051212000318  | 
| Provider Name | Debbie H Hallak | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1154493971 PECOS PAC ID: 5991728792 Enrollment ID: I20060109000868  | 
| Provider Name | Krisha L Horger | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1780639302 PECOS PAC ID: 6709890049 Enrollment ID: I20060126000098  | 
| Provider Name | Muhammad Y Hamdan | 
|---|---|
| Provider Type | Practitioner - Hematology/oncology | 
| Provider Identifiers | NPI Number: 1528091980 PECOS PAC ID: 9234225566 Enrollment ID: I20071107000613  | 
| Provider Name | Donald L Porter | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1518955632 PECOS PAC ID: 9830002310 Enrollment ID: I20080115000046  | 
| Provider Name | Mohammed S Shaik | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1679764997 PECOS PAC ID: 4789752981 Enrollment ID: I20081001000074  | 
| Provider Name | Ronald A Hyde | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1215127162 PECOS PAC ID: 0648329250 Enrollment ID: I20090601000068  | 
| Provider Name | Mohammed A Hashem | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1225293277 PECOS PAC ID: 5991855124 Enrollment ID: I20090610000380  | 
| Provider Name | Wihib A Gebregeorgis | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1366632713 PECOS PAC ID: 8729139522 Enrollment ID: I20090707000371  | 
| Provider Name | Adriss E Faraj | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1902014509 PECOS PAC ID: 9739231929 Enrollment ID: I20090720000168  | 
| Provider Name | David W Luginbill | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1275598971 PECOS PAC ID: 9032263702 Enrollment ID: I20090814000043  | 
| Provider Name | Jenifer E Krause | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1790759801 PECOS PAC ID: 8729973193 Enrollment ID: I20091124000350  | 
| Provider Name | Andrew Michael Zwyghuizen | 
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery | 
| Provider Identifiers | NPI Number: 1861514002 PECOS PAC ID: 8921139122 Enrollment ID: I20100702000401  | 
| Provider Name | Mark W Warner | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1780784991 PECOS PAC ID: 4183748791 Enrollment ID: I20100903000478  | 
| Provider Name | Ikjot Kaur | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1174723126 PECOS PAC ID: 0042406258 Enrollment ID: I20101130001239  | 
| Provider Name | Elizabeth A Hanna | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1588964100 PECOS PAC ID: 6305033317 Enrollment ID: I20101202001190  | 
| Provider Name | Syed T Ahmed | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1326097627 PECOS PAC ID: 0547270100 Enrollment ID: I20110427000729  | 
| Provider Name | Praveen K Vemula | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1891958922 PECOS PAC ID: 5395923759 Enrollment ID: I20110707000279  | 
| Provider Name | David B Minnick | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1063616167 PECOS PAC ID: 8527238849 Enrollment ID: I20110824000449  | 
| Provider Name | Papia Kar | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1932344488 PECOS PAC ID: 9335319508 Enrollment ID: I20110825000192  | 
| Provider Name | Kelli Lynn Isralson Brown | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1235418138 PECOS PAC ID: 7618148537 Enrollment ID: I20110923000540  | 
| Provider Name | Bryan A Kovas | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1063684769 PECOS PAC ID: 8426221599 Enrollment ID: I20111105000098  | 
| Provider Name | Kay L Mclaughlin | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1407827868 PECOS PAC ID: 8628981107 Enrollment ID: I20120119000227  | 
| Provider Name | Gregory A Holzhei | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1073585444 PECOS PAC ID: 6800062860 Enrollment ID: I20120209000608  | 
| Provider Name | Mythri A Ramegowda | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1801174693 PECOS PAC ID: 5698937001 Enrollment ID: I20120501000713  | 
| Provider Name | Tolam Thi Nguyen | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1437311339 PECOS PAC ID: 3476718602 Enrollment ID: I20120712000822  | 
| Provider Name | Malihe Rezazadegan | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1154563369 PECOS PAC ID: 8628227329 Enrollment ID: I20121011000864  | 
| Provider Name | Ijeoma Carol Nwelue | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1689823395 PECOS PAC ID: 2264686740 Enrollment ID: I20130209000043  | 
| Provider Name | Afrina Mujib | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1891948592 PECOS PAC ID: 6507048592 Enrollment ID: I20130401000129  | 
| Provider Name | Aisha Mursaleen | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1376775148 PECOS PAC ID: 2961648993 Enrollment ID: I20130418000191  | 
| Provider Name | Devang Vora | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1952613556 PECOS PAC ID: 2062655830 Enrollment ID: I20130826000913  | 
| Provider Name | Shaza Rafat Khan | 
|---|---|
| Provider Type | Practitioner - Endocrinology | 
| Provider Identifiers | NPI Number: 1366750689 PECOS PAC ID: 1759524499 Enrollment ID: I20130828000972  | 
| Provider Name | Maan Ekkah | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1962632042 PECOS PAC ID: 3678707593 Enrollment ID: I20131009000364  | 
| Provider Name | Sonya Gupta | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1609195395 PECOS PAC ID: 0345478046 Enrollment ID: I20131231001176  | 
| Provider Name | Ali A Al Arab | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1275844524 PECOS PAC ID: 8224255757 Enrollment ID: I20140807000226  | 
| Provider Name | Vishal Saini | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1477866390 PECOS PAC ID: 3779721402 Enrollment ID: I20140929002648  | 
| Provider Name | Anas Alsara | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1932498599 PECOS PAC ID: 9638399819 Enrollment ID: I20141010001120  | 
| Provider Name | Ahmed M Salama | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1801026752 PECOS PAC ID: 7315168721 Enrollment ID: I20141029000779  | 
| Provider Name | Susan M Ott | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1447328299 PECOS PAC ID: 4981770849 Enrollment ID: I20150323000399  | 
| Provider Name | Richa Tikaria | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1669727715 PECOS PAC ID: 1052631728 Enrollment ID: I20150520000993  | 
| Provider Name | Ali R Hazimeh | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1437413721 PECOS PAC ID: 3375854052 Enrollment ID: I20150622002162  | 
| Provider Name | Gregory A Flermoen | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1508178682 PECOS PAC ID: 7810126372 Enrollment ID: I20150706002081  | 
| Provider Name | Samer Kanno | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1013271147 PECOS PAC ID: 8527282458 Enrollment ID: I20150715001383  | 
| Provider Name | Lukasz T Polisiakiewicz | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1295033819 PECOS PAC ID: 3577876606 Enrollment ID: I20150720000805  | 
| Provider Name | Waleed A Obaid | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1003187295 PECOS PAC ID: 3173830650 Enrollment ID: I20150916000400  | 
| Provider Name | Hussein Moustapha Ali-ahmad | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1821262676 PECOS PAC ID: 4880769181 Enrollment ID: I20150930002030  | 
| Provider Name | Noah P Thormeier | 
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology | 
| Provider Identifiers | NPI Number: 1790048528 PECOS PAC ID: 6709195571 Enrollment ID: I20151016001675  | 
| Provider Name | Abdul Kareem Sharaf | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1720344880 PECOS PAC ID: 5395045173 Enrollment ID: I20151201000133  | 
| Provider Name | Syed S Qadri | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1619233749 PECOS PAC ID: 1355648692 Enrollment ID: I20160331000390  | 
| Provider Name | Katie L Ryan | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1255745857 PECOS PAC ID: 3971801507 Enrollment ID: I20160415000814  | 
| Provider Name | Ahmad M Yasin | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1598007510 PECOS PAC ID: 4587973318 Enrollment ID: I20160428000992  | 
| Provider Name | Ikechukwu Chris Ilochonwu | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1558505438 PECOS PAC ID: 5991940652 Enrollment ID: I20160505001705  | 
| Provider Name | Abdul Safadi | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1659544252 PECOS PAC ID: 5294998779 Enrollment ID: I20160607002315  | 
| Provider Name | Riad Al Natour | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1891059077 PECOS PAC ID: 2365680600 Enrollment ID: I20160617001641  | 
| Provider Name | Allison S Keel | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1629411921 PECOS PAC ID: 7911227566 Enrollment ID: I20160714000047  | 
| Provider Name | Victor A Elgabalawi | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1104143296 PECOS PAC ID: 8022301530 Enrollment ID: I20160721000265  | 
| Provider Name | James K Taulbee | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1972843167 PECOS PAC ID: 6709179237 Enrollment ID: I20160721001225  | 
| Provider Name | Mark Weismiller | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1205128816 PECOS PAC ID: 7810287968 Enrollment ID: I20160729000739  | 
| Provider Name | Suneil K Aggarwal | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1396152328 PECOS PAC ID: 4486947348 Enrollment ID: I20160729001075  | 
| Provider Name | Jawad Vaid | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1750600029 PECOS PAC ID: 4880828193 Enrollment ID: I20160808001901  | 
| Provider Name | Alex Gilde | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1548674625 PECOS PAC ID: 7517182132 Enrollment ID: I20160922001236  | 
| Provider Name | Robert Russell Hillman | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1578837332 PECOS PAC ID: 3476836545 Enrollment ID: I20170215001999  | 
| Provider Name | Suresh K Subedi | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1699181552 PECOS PAC ID: 6406073253 Enrollment ID: I20170519000148  | 
| Provider Name | Turab Raza | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1629480561 PECOS PAC ID: 6901173855 Enrollment ID: I20170524000795  | 
| Provider Name | Pritha Chitagi | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1811316813 PECOS PAC ID: 4385940063 Enrollment ID: I20170726002677  | 
| Provider Name | Brian M Kamer | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1124368360 PECOS PAC ID: 4082988365 Enrollment ID: I20170926000949  | 
| Provider Name | Kristina Lombardi | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1952891376 PECOS PAC ID: 0648535369 Enrollment ID: I20180530002838  | 
| Provider Name | Laura Bohatch | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1942681226 PECOS PAC ID: 2668727827 Enrollment ID: I20180612003156  | 
| Provider Name | Ryan A Keating | 
|---|---|
| Provider Type | Practitioner - Neurology | 
| Provider Identifiers | NPI Number: 1245675982 PECOS PAC ID: 0547554560 Enrollment ID: I20180618002724  | 
| Provider Name | Kathryn Das | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1750760542 PECOS PAC ID: 1951656669 Enrollment ID: I20180621000773  | 
| Provider Name | Laura Fanning | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1851886469 PECOS PAC ID: 2163770058 Enrollment ID: I20180809001028  | 
| Provider Name | Wendy Wildern | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1164917787 PECOS PAC ID: 6800144627 Enrollment ID: I20180809004946  | 
| Provider Name | Heba Mahmoud | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1659763365 PECOS PAC ID: 5597066159 Enrollment ID: I20180816003069  | 
| Provider Name | Amrita Jaswa | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1467834408 PECOS PAC ID: 6608126933 Enrollment ID: I20180907001918  | 
| Provider Name | Grace Stephan | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1255714572 PECOS PAC ID: 4981994951 Enrollment ID: I20180924002032  | 
| Provider Name | Elissa M Yarnold | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1801245337 PECOS PAC ID: 2365796133 Enrollment ID: I20181114000314  | 
| Provider Name | Shawn Cuyler Dowling | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1063753606 PECOS PAC ID: 8527299924 Enrollment ID: I20190131000520  | 
| Provider Name | Michael J Kehdi | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1770929820 PECOS PAC ID: 2062751308 Enrollment ID: I20190304000756  | 
| Provider Name | Farashin Farhan Silevany | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1265819171 PECOS PAC ID: 0042550576 Enrollment ID: I20190320002033  | 
| Provider Name | Abigail A Whitten | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1174085484 PECOS PAC ID: 2769724384 Enrollment ID: I20190501002062  | 
| Provider Name | Sana Iqbal | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1548601552 PECOS PAC ID: 0941502108 Enrollment ID: I20190815002616  | 
| Provider Name | Thais A Fortes | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1710399902 PECOS PAC ID: 4688913668 Enrollment ID: I20191023000033  | 
| Provider Name | Kelsey A Thelen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1447899745 PECOS PAC ID: 9234567173 Enrollment ID: I20200309000054  | 
| Provider Name | Monica K Urbanowski | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1376063677 PECOS PAC ID: 8527337112 Enrollment ID: I20200713002902  | 
| Provider Name | Lissette E Jimenez | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1932631322 PECOS PAC ID: 6507133279 Enrollment ID: I20200722001128  | 
| Provider Name | Emir Kurtovic | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1952783169 PECOS PAC ID: 0446676225 Enrollment ID: I20200723002762  | 
| Provider Name | Mahwish A Hafeez | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1518491059 PECOS PAC ID: 1052684859 Enrollment ID: I20200728001015  | 
| Provider Name | Shiva Shrotriya | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1538689740 PECOS PAC ID: 6800211277 Enrollment ID: I20200731001864  | 
| Provider Name | Razik Z Oumeddour | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1134577612 PECOS PAC ID: 1951657873 Enrollment ID: I20200814002271  | 
| Provider Name | Dorothy Martinez | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1326646050 PECOS PAC ID: 8426460056 Enrollment ID: I20201223001310  | 
| Provider Name | Brittany Glynn | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1902385743 PECOS PAC ID: 4789097825 Enrollment ID: I20210108000683  | 
| Provider Name | Shahrzad Brown | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1235509266 PECOS PAC ID: 1850682931 Enrollment ID: I20210528002038  | 
| Provider Name | Lauren B Kwasny | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1417303108 PECOS PAC ID: 2264729805 Enrollment ID: I20210726003234  | 
| Provider Name | Joshua M Hamoud | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1427407253 PECOS PAC ID: 8325334683 Enrollment ID: I20211201001289  | 
| Provider Name | Angad S Pordal | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1437688462 PECOS PAC ID: 7517342850 Enrollment ID: I20220922000969  | 
| Provider Name | Anna O'rourke | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1548812266 PECOS PAC ID: 9436514841 Enrollment ID: I20230508000414  | 
| Provider Name | Daniela M Weiss | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1770011603 PECOS PAC ID: 8921378910 Enrollment ID: I20230622002723  | 
| Provider Name | Eric M Pittelkow | 
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery | 
| Provider Identifiers | NPI Number: 1982050340 PECOS PAC ID: 4880985423 Enrollment ID: I20230725000835  | 
| Provider Name | Stephanie A Schmitt | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1396497525 PECOS PAC ID: 9638531676 Enrollment ID: I20230808003178  | 
| Provider Name | Whitnee Essenmacher | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1831707595 PECOS PAC ID: 7719420678 Enrollment ID: I20240828002198  | 
| Provider Name | Sarah Al Taii | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1316514102 PECOS PAC ID: 5991109175 Enrollment ID: I20241002001271  | 
| Provider Name | Amanda Borbonus | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1295254100 PECOS PAC ID: 3375076896 Enrollment ID: I20241023000205  | 
North Wilton Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1101 S Scott Rd, Saint Johns, MI 48879 Phone: 989-224-8936  | |
St. Johns Internal Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 W Higham St, Saint Johns, MI 48879 Phone: 989-224-0646  | |
St Johns Family Health Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1505 Waterford Pkwy, Saint Johns, MI 48879 Phone: 989-227-0710 Fax: 989-224-0863  | |
Anthony Marl Do Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1505 Waterford Pkwy, Saint Johns, MI 48879 Phone: 989-227-1621  | |
Sheila Gendich M D Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 N Us Highway 27, Saint Johns, MI 48879 Phone: 989-227-9902 Fax: 989-227-9911  | |
Sparrow Clinton Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 S Oakland St Fl 3, Saint Johns, MI 48879 Phone: 989-227-3345 Fax: 989-227-3361  |