Anne-Mare Ice MD PC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

4301031683 Issued in MI

Legal business name

ANNE-MARE ICE MD PC

Practice address

22341 W 8 Mile Rd
Detroit, MI 48219-1217

Phone

(313) 255-2209

NPI assigned

Feb 13, 2008

Last updated

Feb 13, 2008By 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

Mrs. Kassandra A Hill

Title

General Manager

Phone

(313) 255-4672

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1639347586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22341 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22341 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191217",
            "telephone_number": "313-255-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE-MARE ICE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "KASSANDRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "313-255-4672",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301031683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0H27243",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1066910",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anjali Kumar
• Adnan Anjary, MD
• Faraz Anjum, DPT
• Ahmed Hassan Ankouni, RPH
• Ann Cook Dialysis Center
• Premchand Anne, M.D., M.B.A., M.P.H.
• Annie's Angels LLC
• Annies Nurturing Nest LLC
• Annthony Rockette (anthony rockkette)
• Peter Santo Annyschyn, D.C.

• Pediatric Adolescent Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.