Kertia Libretto Black, MD | |
27725 Rainbow Cir, Lathrup Village, MI 48076-3238 | |
(248) 910-7018 | |
(248) 557-5409 |
Full Name | Kertia Libretto Black |
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Gender | Female |
Speciality | Physical Medicine & Rehabilitation |
Location | 27725 Rainbow Cir, Lathrup Village, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467499954 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208100000X | Physical Medicine & Rehabilitation | 4301061932 (Michigan) | Primary |
Entity Name | University Physician Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447299797 PECOS PAC ID: 8628087681 Enrollment ID: O20060419000518 |
Entity Name | Kertia Black Md Board Certified In Rehabilitation Medicine |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902422363 PECOS PAC ID: 7810312345 Enrollment ID: O20200731000259 |
Mailing Address | Practice Location Address |
---|---|
Kertia Libretto Black, MD 27725 Rainbow Cir, Lathrup Village, MI 48076-3238 Ph: (248) 910-7018 | Kertia Libretto Black, MD 27725 Rainbow Cir, Lathrup Village, MI 48076-3238 Ph: (248) 910-7018 |
James Thomas Gilas, M. D. Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 26635 Southfield Rd, Lathrup Village, MI 48076 Phone: 248-563-5502 | |
Payaum Fotovat-ahmadi, MD Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 27270 Evergreen Rd, Lathrup Village, MI 48076 Phone: 734-812-0429 | |
Dr. Abiola Dianne Adisa-obayan, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 26333 Southfield Rd Ste 103, Lathrup Village, MI 48076 Phone: 248-331-1900 |