Lada Medical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LADA MEDICAL

Practice address

7867 Timberlane TRL
West Bloomfield, MI 48323-4012

Phone

(248) 613-4835

Fax

(248) 613-4835

NPI assigned

Nov 7, 2017

Last updated

Nov 7, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Deangelo Shathaya

Title

President

Phone

(248) 613-4835

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1194238642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7867 TIMBERLANE TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483234012",
            "telephone_number": "248-613-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7867 TIMBERLANE TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483234012",
            "telephone_number": "248-613-4835",
            "fax_number": "248-613-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADA MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "SHATHAYA",
        "authorized_official_first_name": "DEANGELO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-613-4835",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatyana Kuzminsky, RD MHSA
• Mark Andrew Kwartowitz, DO
• Katie Labarre
• Nicholas Labus
• Alexsandra Aquila Lachance, MSN, APRN, FNP-C
• Scott A Laker, MD
• Lakes Anesthesia, PLC
• Lakes Area Hospitalists,PC
• Lakes Psychiatric Center, PLLC (LPCC, PLLC)
• Lakes Urgent Care Inc

• Durable Medical Equipment & Medical Supplies in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.