South Eastern Michigan Colon & Rectal Surgery

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY

Practice address

3106 S Wayne Rd
Wayne, MI 48184-1221

Phone

(734) 722-1063

Fax

(734) 722-4815

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Adewunmi Adeyemo, DONPI 1427289883

Title

Owner

Phone

(743) 722-6300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Adewunmi Adeyemo, MD

  • Surgery Physician
  • Wayne, MI
  • NPI 1427289883

  Colon & Rectal Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1497119689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 S WAYNE RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841221",
            "telephone_number": "734-722-1063",
            "fax_number": "734-722-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 S WAYNE RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841221",
            "telephone_number": "734-722-1063",
            "fax_number": "734-722-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "ADEYEMO",
        "authorized_official_first_name": "ADEWUNMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "743-722-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497119689",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mikhayl Samy Soliman, M.D.
• Heather Marie Somand, PHARMD
• Arunkumar Somasundaram, LLMSW,QIDP
• Theresa Sommerville
• Rakesh Soni, MD
• Susan Southerland-Stricker, RN
• Kimberly Sparks, PT, DPT
• Josie Rene Spolyar
• Erin Joi Staley
• Stars Investment Inc

• Colon & Rectal Surgery Physician in Wayne, MI
• Providers in Wayne, MI by specialty
• Colon & Rectal Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.