| Mrc Inc | |
|
21700 Greenfield Rd Suite 130 Oak Park MI 48237-2581 | |
| (248) 967-4310 | |
| (248) 967-4301 |
| Full Name | Mrc Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21700 Greenfield Rd, Oak Park, Michigan |
| Authorized Official Name and Position | Ammar Mehdi Khan (PRESIDENT) |
| Authorized Official Contact | 2489674310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mrc Inc Po Box 221 Southfield MI 48037-0221 Ph: (248) 967-4310 | Mrc Inc 21700 Greenfield Rd Suite 130 Oak Park MI 48237-2581 Ph: (248) 967-4310 |
| NPI Number | 1811020035 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 04/03/2018 |
| Medicare PECOS PAC ID | 8022039742 |
|---|---|
| Medicare Enrollment ID | O20051209000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811020035 | NPI | - | NPPES |
| 20445 | Other | MI | BLUE CROSS BLUE SHIELD |
| Provider Name | Gena A Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942592167 PECOS PAC ID: 0143218057 Enrollment ID: I20040430001162 |
| Provider Name | Marcella Clark |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1902028913 PECOS PAC ID: 9234236431 Enrollment ID: I20070523000335 |
| Provider Name | Andrew J Ruden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881717049 PECOS PAC ID: 7416048012 Enrollment ID: I20070810000785 |
| Provider Name | Raymond Charles Edison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679782346 PECOS PAC ID: 6901955426 Enrollment ID: I20090512000513 |
| Provider Name | Kastytis L Buitkus |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1881638625 PECOS PAC ID: 9931377918 Enrollment ID: I20110718000613 |
| Provider Name | Antonino Agosta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396913497 PECOS PAC ID: 0345482030 Enrollment ID: I20130808000549 |
| Provider Name | Kelsey A Lamb |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194130658 PECOS PAC ID: 0143525360 Enrollment ID: I20180913000847 |
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