| Fulfilled Care | |
|
32000 Northwestern Hwy Ste 165 Farmington Hills MI 48334-1568 | |
| (248) 289-8874 | |
| (351) 207-4647 |
| Full Name | Fulfilled Care |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 32000 Northwestern Hwy Ste 165, Farmington Hills, Michigan |
| Authorized Official Name and Position | Jimmy Metellus (OWNER) |
| Authorized Official Contact | 2482898874 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulfilled Care 32000 Northwestern Hwy Ste 165 Farmington Hills MI 48334-1568 Ph: (248) 289-8874 | Fulfilled Care 32000 Northwestern Hwy Ste 165 Farmington Hills MI 48334-1568 Ph: (248) 289-8874 |
| NPI Number | 1881389260 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 11/19/2023 |
| Certification Date | 11/19/2023 |
| Medicare PECOS PAC ID | 8820459266 |
|---|---|
| Medicare Enrollment ID | O20230801002389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881389260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jimmy Metellus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184187742 PECOS PAC ID: 1557722998 Enrollment ID: I20230801002533 |
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