Normita Davila Vicencio, MD | |
4020 Venoy Road, Suite 300, Wayne, MI 48184 | |
(734) 728-2909 | |
(734) 728-3015 |
Full Name | Normita Davila Vicencio |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Location | 4020 Venoy Road, Wayne, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700973385 | NPI | - | NPPES |
170375810 | Medicaid | MI | |
1108258662 | Other | BCBSM | |
110154734 | Other | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | NV032288 (Michigan) | Primary |
Entity Name | Normita Vicencio Md Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841493616 PECOS PAC ID: 7113019803 Enrollment ID: O20070827000246 |
Mailing Address | Practice Location Address |
---|---|
Normita Davila Vicencio, MD 4020 Venoy Road, Suite 300, Wayne, MI 48184 Ph: (734) 728-2909 | Normita Davila Vicencio, MD 4020 Venoy Road, Suite 300, Wayne, MI 48184 Ph: (734) 728-2909 |
Ruta Sharangpani, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 33030 Van Born Rd, Wayne, MI 48184 Phone: 734-727-7010 | |
Dr. Chandrakant H Pujara, M.D Internal Medicine Medicare: Medicare Enrolled Practice Location: 4020 Venoy Rd, Suite 200, Wayne, MI 48184 Phone: 734-729-6710 Fax: 734-729-6715 | |
Jairaj D Mulchandani, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 32320 Michigan Ave, Wayne, MI 48184 Phone: 734-641-3630 Fax: 734-641-1520 | |
Mohamad El Abdallah, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 33155 Annapolis St, Wayne, MI 48184 Phone: 734-467-4000 Fax: 734-467-4017 | |
Dr. Sasi B Boppana, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 34659 W Michigan Ave, Wayne, MI 48184 Phone: 734-722-2400 Fax: 734-722-1709 | |
Khawar Aslam Chaudhry, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 34815 W Michigan Ave Ste 1, Wayne, MI 48184 Phone: 734-713-7189 Fax: 734-263-1295 | |
Dr. Kavitha Ponduri, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 34659 W Michigan Ave, Wayne, MI 48184 Phone: 734-722-2400 Fax: 734-722-1709 |