Michael Kubek Iv, DO | |
19805 Crystal Lake Dr, Northville, MI 48167-2522 | |
(248) 449-6425 | |
Not Available |
Full Name | Michael Kubek Iv |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 19805 Crystal Lake Dr, Northville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922270933 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 5101016047 (Michigan) | Primary |
207P00000X | Emergency Medicine | 02003348A (Indiana) | Secondary |
Entity Name | St. Vincent Emergency Physicians, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306891700 PECOS PAC ID: 1759363450 Enrollment ID: O20040720000734 |
Entity Name | Indiana Physician Management-northeast, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740431576 PECOS PAC ID: 0941363071 Enrollment ID: O20090115000124 |
Entity Name | Indiana Physician Management Rush Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821364654 PECOS PAC ID: 7618130014 Enrollment ID: O20120523000003 |
Entity Name | Indiana Physician Management - Mercy Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225309073 PECOS PAC ID: 6800051319 Enrollment ID: O20120709000441 |
Entity Name | Cep America Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285103671 PECOS PAC ID: 6608056171 Enrollment ID: O20190214000611 |
Mailing Address | Practice Location Address |
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Michael Kubek Iv, DO 6245 Inkster Rd, Garden City, MI 48135-4001 Ph: (734) 458-3430 | Michael Kubek Iv, DO 19805 Crystal Lake Dr, Northville, MI 48167-2522 Ph: (248) 449-6425 |