Dr. John S Inthavongsa
DNP RN AGACNP-BC | Nurse Practitioner | 6+ years Exp
4201 Saint Antoine St, Detroit
Michigan, 48201-2153
313-745-3000
Dr. John S Inthavongsa is a Detroit, Michigan based nurse practitioner with 6 years of experience in Nurse Practitioner. He completed his graduation from University Of Michigan Medical School in 2019. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. John S Inthavongsa is 4704309696 for Acute Care in Michigan. His current practice location is 4201 Saint Antoine St, Detroit. Patients can reach him at 313-745-3000 or can fax him at 313-745-4707. Dr. John S Inthavongsa is DNP RN AGACNP-BC with specialization in Nurse Practitioner and his NPI number (Unique professional ID assigned by NPPES) is 1588220222.
Dr. John S Inthavongsa has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Dr. John S Inthavongsa speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Dr. John S Inthavongsa |
| Specialization: | Nurse Practitioner Nurse Practitioner (NP) |
| Gender: | Male |
| Credentials: | DNP RN AGACNP-BC |
| Experience: | 6+ years |
| Medical School Attended: | University Of Michigan Medical School |
| Graduation Year: | 2019 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 4201 Saint Antoine St, Detroit,
Michigan, 48201-2153 |
| Phone: | 313-745-3000 |
| Fax: | 313-745-4707 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 9133451008 |
| Enrollment ID: | I20191025000382 |
| NPI Number: | 1588220222 |
| NPI Enumeration Date: | 17 May, 2019 |
| NPI Last Update On: | 04 Jun, 2021 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. John S Inthavongsa are as mentioned below.
| License Number | Specialization | State | Status | |
| 4704309696 | Acute Care | Michigan | Primary | |
| 4704309696 | Registered Nurse | Michigan | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Dr. John S Inthavongsa is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| University Physician Group (8628087681) | 355 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Dr. John S Inthavongsa
454 W Alexandrine St Apt 18,
Detroit, Michigan |
| Zip: | 48201-1787 |
| Phone Number: | 347-963-1896 |
Patients can reach Dr. John S Inthavongsa at
4201 Saint Antoine St, Detroit, Michigan or can
call to book an appointment on 313-745-3000.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.