Northwestern Psychiatry & Counseling Center Pc | |
26699 W 12 Mile Rd Ste 100 Southfield MI 48034-1578 | |
(248) 945-9370 | |
(248) 945-9377 |
Full Name | Northwestern Psychiatry & Counseling Center Pc |
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Speciality | Psychiatry & Neurology |
Location | 26699 W 12 Mile Rd Ste 100, Southfield, Michigan |
Authorized Official Name and Position | Madhu Mendiratta (MD) |
Authorized Official Contact | 2489459370 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northwestern Psychiatry & Counseling Center Pc 26699 W 12 Mile Rd Ste 100 Southfield MI 48034-1578 Ph: (248) 945-9370 | Northwestern Psychiatry & Counseling Center Pc 26699 W 12 Mile Rd Ste 100 Southfield MI 48034-1578 Ph: (248) 945-9370 |
NPI Number | 1275671968 |
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Provider Enumeration Date | 02/02/2007 |
Last Update Date | 06/30/2014 |
Medicare PECOS PAC ID | 8527163963 |
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Medicare Enrollment ID | O20070413000401 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275671968 | NPI | - | NPPES |
2606351352 | Other | MI | BCBCM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | MM048520 (Michigan) | Primary |
Provider Name | Madhu Mendiratta |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1467447441 PECOS PAC ID: 0840393633 Enrollment ID: I20070315000365 |
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