Dr Brooke M Buckley, MD | |
2333 Biddle Ave, Wyandotte, MI 48192-4668 | |
(734) 246-6000 | |
Not Available |
Full Name | Dr Brooke M Buckley |
---|---|
Gender | Female |
Speciality | Surgery |
Location | 2333 Biddle Ave, Wyandotte, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154514602 | NPI | - | NPPES |
91645102 | Other | CAREFIRST MARYLAND | |
607156013 | Other | DEPT OF LABOR | |
413562800 | Medicaid | MD | |
V7930013 | Other | CAREFIRST DC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 4301502392 (Michigan) | Primary |
208600000X | Surgery | D0066466 (Maryland) | Secondary |
Entity Name | Luminis Health Medical Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073580205 PECOS PAC ID: 2860447315 Enrollment ID: O20050317000146 |
Mailing Address | Practice Location Address |
---|---|
Dr Brooke M Buckley, MD 1 Ford Pl Ste 2e, Detroit, MI 48202-3450 Ph: (313) 874-4806 | Dr Brooke M Buckley, MD 2333 Biddle Ave, Wyandotte, MI 48192-4668 Ph: (734) 246-6000 |
Anthony Campbell, Surgery Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 | |
Dr. Christine Marie Joliat, MD Surgery Medicare: Medicare Enrolled Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Fadi Baidoun, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Suite C, Wyandotte, MI 48192 Phone: 734-324-3330 Fax: 734-324-3303 | |
Jack Avedikian, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Ahmad Abukhader, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Dr. Marcus Tyler Brown, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 |