Intervisions Pc | |
20811 Kelly Eastpointe MI 48021 | |
(586) 445-3612 | |
(586) 445-0700 |
Full Name | Intervisions Pc |
---|---|
Speciality | Psychologist |
Location | 20811 Kelly, Eastpointe, Michigan |
Authorized Official Name and Position | Charles Raymond Stern (PSYCHOLOGIST) |
Authorized Official Contact | 5864453612 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Intervisions Pc 1839 Shipman Birmingham MI 48009 Ph: (586) 445-3612 | Intervisions Pc 20811 Kelly Eastpointe MI 48021 Ph: (586) 445-3612 |
NPI Number | 1730243262 |
---|---|
Provider Enumeration Date | 12/20/2006 |
Last Update Date | 03/05/2008 |
Medicare PECOS PAC ID | 9739265760 |
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Medicare Enrollment ID | O20080331000337 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730243262 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 6301005261 (Michigan) | Primary |
Provider Name | Charles R Stern |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1952400848 PECOS PAC ID: 0749366763 Enrollment ID: I20080331000318 |
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