Pinetree Medical Center, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PINETREE MEDICAL CENTER, PC

Practice address

4186 Pontiac Lake Rd
Waterford, MI 48328-1258

Phone

(248) 935-1931

NPI assigned

Jun 9, 2008

Last updated

Aug 29, 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

Dr. Shamim A Islam, MDNPI 1730187592

Title

Ceo

Phone

(248) 935-1931

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shamim Islam, MD

  • Pediatrics Physician
  • Waterford, MI
  • NPI 1730187592
  Authorized official Same address or phone

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1699934158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4186 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281258",
            "telephone_number": "248-935-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4186 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281258",
            "telephone_number": "248-935-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINETREE MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "SHAMIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-935-1931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F32626",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wayne Eric Pickett, DDS
• Julie Renee Pieciak
• Cheri Hope Pierce, LLMSW
• Pikal PLC
• Robert J Pikal, M.D.
• Kristin Darrach Piper, DDS
• Amber Pittaway, PROVIDER
• Courtney Aunyell Pittman
• Plaine Physical Therapy, LLC
• Sara Lori Platz, LLMSW

• Pediatrics Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.