Dearborn Allergy & Asthma Clinic PC

Primary specialty

Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X

Legal business name

DEARBORN ALLERGY & ASTHMA CLINIC PC

Practice address

20200 Outer Dr
Dearborn, MI 48124-2634

Phone

(313) 565-3565

Fax

(313) 565-7723

NPI assigned

Aug 18, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kathy Short

Title

Office Manager

Phone

(313) 565-3565

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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

• Diane L Baranowski, MD

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • Dearborn, MI
  • NPI 1750359204
  Medicare reassignment Care Compare group NPD
• Sonia Lynn Thomas, MD

  • Allergy & Immunology Physician
  • Dearborn, MI
  • NPI 1043650732
  Medicare reassignment Care Compare group NPD
• Ashraf Uzzaman, M.D.

  • Allergy & Immunology Physician
  • Saline, MI
  • NPI 1568624773
  Medicare reassignment
• Faina M Gutin, MD

  • Allergy & Immunology Physician
  • Trenton, NJ
  • NPI 1578666707
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1477545200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20200 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242634",
            "telephone_number": "313-565-3565",
            "fax_number": "313-565-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242634",
            "telephone_number": "313-565-3565",
            "fax_number": "313-565-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN ALLERGY & ASTHMA CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-565-3565",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083483",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2838806",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H26340",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1290003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliezer R De Leon, M.D.
• Mario JC De Meireles, MD
• Chelsea Dean, BSN
• Molly Dean
• Theresa Ann Dean, FNP-C, CNM
• Dearborn Apothecary LLC
• Dearborn Auto Injury Center LLC
• Dearborn Behavioral Counseling and ABA Therapy Center PLLC
• Dearborn Caremor Pharmacy
• Dearborn Center for Physical Therapy

• Allergy & Immunology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.