| David G. Mikkola Lmsw Pc | |
|
30200 Telegraph Rd Suite 402 Bingham Farms MI 48025-4502 | |
| (248) 644-3200 | |
| (248) 644-3211 |
| Full Name | David G. Mikkola Lmsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 30200 Telegraph Rd, Bingham Farms, Michigan |
| Authorized Official Name and Position | David George Mikkola (PRESIDENT) |
| Authorized Official Contact | 2486443200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David G. Mikkola Lmsw Pc 30200 Telegraph Rd Suite 402 Bingham Farms MI 48025-4502 Ph: (248) 644-3200 | David G. Mikkola Lmsw Pc 30200 Telegraph Rd Suite 402 Bingham Farms MI 48025-4502 Ph: (248) 644-3200 |
| NPI Number | 1376707463 |
|---|---|
| Provider Enumeration Date | 07/17/2008 |
| Last Update Date | 07/17/2008 |
| Medicare PECOS PAC ID | 1254407497 |
|---|---|
| Medicare Enrollment ID | O20080911000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376707463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 680103141 (Michigan) | Primary |
| Provider Name | David G Mikkola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528258456 PECOS PAC ID: 6800962044 Enrollment ID: I20080911000496 |
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