| Smg St Johns | |
|
901 S Oakland St Saint Johns MI 48879-2200 | |
| (989) 224-2338 | |
| (989) 224-2065 |
| Full Name | Smg St Johns |
|---|---|
| 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 |
|---|---|
| Smg St Johns 8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (517) 364-6287 | Smg St Johns 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 |
| Certification 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 - Internal Medicine |
| 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 | 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 | Tanna Sue Mcgee |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871505644 PECOS PAC ID: 8729052717 Enrollment ID: I20040825000211 |
| 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 | Heidi Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972501138 PECOS PAC ID: 0345330593 Enrollment ID: I20071212000402 |
| 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 | Miranda F Cristales |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508023151 PECOS PAC ID: 4486715570 Enrollment ID: I20081208000477 |
| 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 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 | Donald a Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568779940 PECOS PAC ID: 3173711397 Enrollment ID: I20110103000420 |
| Provider Name | Syed T Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326097627 PECOS PAC ID: 0547270100 Enrollment ID: I20110427000729 |
| 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 | Melani R Vos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740565704 PECOS PAC ID: 7911173315 Enrollment ID: I20120106000402 |
| 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 | 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 - Family Practice |
| 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 | Sean a Cameron |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518392232 PECOS PAC ID: 3476786914 Enrollment ID: I20140507001326 |
| 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 | Waleed 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 | Danielle M Barber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265800999 PECOS PAC ID: 2769790211 Enrollment ID: I20151001002671 |
| Provider Name | Julie Simon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851761217 PECOS PAC ID: 3971811126 Enrollment ID: I20151007002883 |
| Provider Name | Noah P Thormeier |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1790048528 PECOS PAC ID: 6709195571 Enrollment ID: I20151016001675 |
| Provider Name | Amy K Nostrant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952779571 PECOS PAC ID: 5799094363 Enrollment ID: I20151021002471 |
| Provider Name | Tricia I Lozon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760848634 PECOS PAC ID: 2961705702 Enrollment ID: I20160128000441 |
| Provider Name | Meghan R Mikula |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497112890 PECOS PAC ID: 8426351271 Enrollment ID: I20160128000762 |
| 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 | Riad Al Natour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| 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 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 | 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 | Paige Wiegel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174012066 PECOS PAC ID: 6608131313 Enrollment ID: I20180530002530 |
| Provider Name | Kristina Lombardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952891376 PECOS PAC ID: 0648535369 Enrollment ID: I20180530002838 |
| 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 | Arya Khatiwoda |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609213636 PECOS PAC ID: 7517212046 Enrollment ID: I20180625000249 |
| 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 | Kristyn Severson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265919195 PECOS PAC ID: 3476804337 Enrollment ID: I20180920003445 |
| 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 | Laura J Brechting |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174944888 PECOS PAC ID: 3870821085 Enrollment ID: I20190827000649 |
| Provider Name | Leah Koetje |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871908921 PECOS PAC ID: 7214228634 Enrollment ID: I20190913000286 |
| Provider Name | Thais a Fortes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710399902 PECOS PAC ID: 4688913668 Enrollment ID: I20191023000033 |
| Provider Name | Elizabeth K Labutte |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013568500 PECOS PAC ID: 1254763253 Enrollment ID: I20191113000799 |
| 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 | Stephen J Hickner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881191658 PECOS PAC ID: 2668728700 Enrollment ID: I20210819000846 |
| Provider Name | Joshua M Hamoud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427407253 PECOS PAC ID: 8325334683 Enrollment ID: I20211201001289 |
| Provider Name | Katherine M Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740940659 PECOS PAC ID: 4183016942 Enrollment ID: I20220128000386 |
| Provider Name | Mallory Jansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881345031 PECOS PAC ID: 9234522475 Enrollment ID: I20220210000594 |
| 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 | Holly Noelle Hnetynka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114703634 PECOS PAC ID: 0749636538 Enrollment ID: I20231031001603 |
| Provider Name | Glen W Scott |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386245579 PECOS PAC ID: 1850700725 Enrollment ID: I20231207003963 |
| Provider Name | Whitnee Essenmacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831707595 PECOS PAC ID: 7719420678 Enrollment ID: I20240828002198 |
| Provider Name | Sarah R 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 |
| Provider Name | Catherine Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285376483 PECOS PAC ID: 5890203137 Enrollment ID: I20250806002068 |
| Provider Name | Merryl Treasa Varghese |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1891344792 PECOS PAC ID: 9830579184 Enrollment ID: I20250919003123 |
| Provider Name | Derrica Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548128119 PECOS PAC ID: 6709369341 Enrollment ID: I20260312000663 |
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 Wound Clinic 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 |