| International Medical Clinic Pllc | |
|
43902 Woodward Ave Ste 100 Bloomfield MI 48302-5021 | |
| (248) 955-9949 | |
| (248) 928-2274 |
| Full Name | International Medical Clinic Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 43902 Woodward Ave Ste 100, Bloomfield, Michigan |
| Authorized Official Name and Position | Ramesh Madhavan (CEO) |
| Authorized Official Contact | 2489559949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| International Medical Clinic Pllc 43902 Woodward Ave Ste 100 Bloomfield Hills MI 48302-5021 Ph: (248) 955-9949 | International Medical Clinic Pllc 43902 Woodward Ave Ste 100 Bloomfield MI 48302-5021 Ph: (248) 955-9949 |
| NPI Number | 1306473418 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 0941626188 |
|---|---|
| Medicare Enrollment ID | O20200818002534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306473418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Ramesh Madhavan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205863867 PECOS PAC ID: 0345246146 Enrollment ID: I20061019000132 |
| Provider Name | Gregory Michael Norris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821203274 PECOS PAC ID: 5496849333 Enrollment ID: I20070921000717 |
| Provider Name | Basel Assaad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154531937 PECOS PAC ID: 8729104112 Enrollment ID: I20100922000942 |
| Provider Name | Noura F Mansour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942457817 PECOS PAC ID: 3678751682 Enrollment ID: I20110622000288 |
| Provider Name | Pratik D Bhattacharya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528212768 PECOS PAC ID: 1355529116 Enrollment ID: I20110624000550 |
| Provider Name | Omran B Kaskar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629208798 PECOS PAC ID: 9436374378 Enrollment ID: I20140708002246 |
| Provider Name | Priti M George |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972124741 PECOS PAC ID: 5597181958 Enrollment ID: I20200817000315 |
| Provider Name | Julia Kathleen Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215691753 PECOS PAC ID: 7618360744 Enrollment ID: I20220211001641 |
| Provider Name | Vishal B Jani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134350069 PECOS PAC ID: 7214220367 Enrollment ID: I20220401001701 |
| Provider Name | Prasanna Kumar Reddy Tadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689962441 PECOS PAC ID: 3678791241 Enrollment ID: I20221110001669 |
| Provider Name | Alexander Rodrigo Tobar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730746744 PECOS PAC ID: 0840650420 Enrollment ID: I20230713003383 |
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