Michigan Ear Nose and Throat Associates PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

MICHIGAN EAR NOSE AND THROAT ASSOCIATES PC

Practice address

44200 Woodward Ave
Suite 201
Pontiac, MI 48341-5045

Phone

(248) 334-9490

Fax

(248) 636-1170

NPI assigned

May 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sam Bahu, MD

Title

Owner

Phone

(248) 334-9490

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• MICHIGAN EAR NOSE AND THROAT Doing business as
• BASHAR SUCCAR, M.D., P.C. Former legal business name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samer J Bahu, MD

  • Otolaryngology Physician
  • Pontiac, MI
  • NPI 1366547143
  Medicare reassignment Care Compare group
• Evan C Eschker

  • Physician Assistant
  • Pontiac, MI
  • NPI 1376257626
  Medicare reassignment Care Compare group
• Kylie Strange, PA-C

  • Physician Assistant
  • Pontiac, MI
  • NPI 1578353546
  Medicare reassignment Care Compare group
• Daniel Servito, FNP

  • Family Nurse Practitioner
  • Pontiac, MI
  • NPI 1215585005
  Medicare reassignment
• Eric Fahed Succar, MD

  • Otolaryngology Physician
  • Waterford, MI
  • NPI 1124361621
  Medicare reassignment
• Kerolos Shenouda, MD

  • Otolaryngology Physician
  • Toledo, OH
  • NPI 1598129579
  NPD
• Gouthami Sravanthi Erra, M.A.

  • Specialist
  • Pontiac, MI
  • NPI 1821276791
  NPD (past)
• Michael Scott Hayes, M.S., CCC-A

  • Audiologist
  • Pontiac, MI
  • NPI 1043460512
  NPD (past)
• Gail Lynn Weddington, AU.D.

  • Audiologist
  • Pontiac, MI
  • NPI 1699914317
  NPD (past)
• Kelly Leigh Hurd, MS CCC-A

  • Audiologist-Hearing Aid Fitter
  • Auburn, NY
  • NPI 1992859201
  NPD (past)
• Mark D Wilson, M.D.

  • Otolaryngology Physician
  • Rancho Mirage, CA
  • NPI 1376535708
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1073560355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 201",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-334-9490",
            "fax_number": "248-636-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 201",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-334-9490",
            "fax_number": "248-636-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN EAR NOSE AND THROAT ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "BAHU",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-334-9490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4470874",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHIGAN EAR NOSE AND THROAT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BASHAR SUCCAR, M.D., P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Victoria Ann Meyer, LLMSW
• Ikechukwu Mgbudem
• Lucas Miazga, DO
• Michael L. Hicks, MD, PC
• Michael L. Hicks, MD, PC
• Michigan Infectious Disease Consultants PC
• Michigan Institute for Radiation Oncology/Miro Cancer Center
• Michigan Institute of Neurology and Epilepsy PC
• Michigan Maternal Fetal Medicine PLC
• Michigan Moonlighters PLLC

• Otolaryngology Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.