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CORNERSTONE MEDICAL GROUP NPI 1710165089


NPI Information

NPI: 1710165089
Provider Name: CORNERSTONE MEDICAL GROUP

Doing Business As: ST JOHN WEIGHT LOSS INSTITUTE

Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization

CLIA Number: 23D0363881

Address:
43750 GARFIELD RD
SUITE 104
CLINTON TWP, MI
ZIP 48038
Phone: (586) 226-6865
Get Directions

CORNERSTONE MEDICAL GROUP is a dietitian registered in Clinton Twp, MI. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. CORNERSTONE MEDICAL GROUP NPI is 1710165089. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As St John Weight Loss Institute.

The provider's business location address is:

43750 GARFIELD RD
SUITE 104
CLINTON TWP, MI
ZIP 48038-135
Phone: (586) 226-6865
Fax: (586) 226-6880

The provider's authorized official is Phil Hunsberger .
The authorized official title is C.a.o. and has the following contact phone number (586) 226-6937.

The CLIA number assigned to this NPI record is 23D0363881 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2008 and was last updated on 2/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133V00000XDietitian, Registered932504MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10N55210OTHERMICHIGANMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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