| Manuel Dumlao Md Pc | |
|
2314 Monroe St Dearborn MI 48124-3045 | |
| (313) 562-6633 | |
| (313) 562-0880 |
| Full Name | Manuel Dumlao Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2314 Monroe St, Dearborn, Michigan |
| Authorized Official Name and Position | Manuel S Dumlao (PRESIDENT) |
| Authorized Official Contact | 3135626633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manuel Dumlao Md Pc 2314 Monroe St Dearborn MI 48124-3045 Ph: (313) 562-6633 | Manuel Dumlao Md Pc 2314 Monroe St Dearborn MI 48124-3045 Ph: (313) 562-6633 |
| NPI Number | 1164482451 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 01/26/2010 |
| Medicare PECOS PAC ID | 2668411711 |
|---|---|
| Medicare Enrollment ID | O20060503000092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164482451 | NPI | - | NPPES |
| 2608218572 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 4301047459 (Michigan) | Primary |
| Provider Name | David Gurevitch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558321885 PECOS PAC ID: 6002706314 Enrollment ID: I20040319000026 |
| Provider Name | Manuel S Dumlao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184683856 PECOS PAC ID: 6507844198 Enrollment ID: I20040709001293 |
| Provider Name | Norma K Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528003571 PECOS PAC ID: 4385614205 Enrollment ID: I20040728001192 |
| Provider Name | Michelle Farkas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124290267 PECOS PAC ID: 6709955628 Enrollment ID: I20080519000613 |
| Provider Name | Katherine Alison Melchior |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528482155 PECOS PAC ID: 6406087659 Enrollment ID: I20140401001284 |
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