Geetha Krishnamoorthy, MD | |
28411 Northwestern Hwy, Suite # 200, Southfield, MI 48034-5544 | |
(248) 354-4709 | |
(248) 354-4807 |
Full Name | Geetha Krishnamoorthy |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Location | 28411 Northwestern Hwy, Southfield, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790723625 | NPI | - | NPPES |
1346398971 | Other | MI | GROUP NPI |
4301062031 | Other | MI | LICENSE |
110F336360 | Other | MI | BCBSM |
205485614 | Other | MI | TAX ID |
3347713 | Medicaid | MI | |
G53324 | Other | MI | HAP ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301062031 (Michigan) | Primary |
Entity Name | Iha Health Services Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457408965 PECOS PAC ID: 2466351440 Enrollment ID: O20040108000355 |
Entity Name | Iha Ooma Primary Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245815984 PECOS PAC ID: 7012316664 Enrollment ID: O20210601002563 |
Mailing Address | Practice Location Address |
---|---|
Geetha Krishnamoorthy, MD Po Box 674147, Detroit, MI 48267-4147 Ph: (248) 354-4709 | Geetha Krishnamoorthy, MD 28411 Northwestern Hwy, Suite # 200, Southfield, MI 48034-5544 Ph: (248) 354-4709 |
Surinder Mendiratta, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 20905 Greenfield Rd, Suite 502, Southfield, MI 48075 Phone: 248-395-2888 Fax: 248-395-2891 | |
Dr. Freddy R Sosa, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 22250 Providence Dr, Suite 703, Southfield, MI 48075 Phone: 248-569-1770 Fax: 248-443-2439 | |
Kun Kil Yu, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 19189 W 10 Mile Rd, Ste 200, Southfield, MI 48075 Phone: 248-948-7985 Fax: 248-948-9031 | |
Dr. Vilma Drelichman, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 22301 Foster Winter Dr, 2nd Floor, Southfield, MI 48075 Phone: 248-552-0620 Fax: 248-552-0286 | |
Dr. Sumner Camisa, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 29829 Telegraph Road, #100, Southfield, MI 48034 Phone: 248-355-3033 Fax: 248-355-4936 | |
Talal Taher Khader, M.D Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 16001 W 9 Mile Rd, 4th Fl Fisher Ctr, Southfield, MI 48075 Phone: 248-849-8483 | |
Dr. Herman Kado, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 28625 Northwestern Hwy, Suite 150, Southfield, MI 48034 Phone: 248-587-2300 Fax: 248-945-0492 |