| Sudad Louis Md Pllc | |
|
31500 Dequindre Rd Ste 500 Warren MI 48092-1057 | |
| (586) 939-9500 | |
| (586) 939-9501 |
| Full Name | Sudad Louis Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 31500 Dequindre Rd Ste 500, Warren, Michigan |
| Authorized Official Name and Position | Sudad Louis (NEUROLOGY) |
| Authorized Official Contact | 2487984797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sudad Louis Md Pllc 31500 Dequindre Rd Suite 500 Warren MI 48092-1057 Ph: (586) 268-5440 | Sudad Louis Md Pllc 31500 Dequindre Rd Ste 500 Warren MI 48092-1057 Ph: (586) 939-9500 |
| NPI Number | 1760847651 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 02/05/2016 |
| Medicare PECOS PAC ID | 7315243920 |
|---|---|
| Medicare Enrollment ID | O20160308002100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760847651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301092292 (Michigan) | Primary |
| Provider Name | Anthony A Bennett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801866397 PECOS PAC ID: 0749176394 Enrollment ID: I20040223000471 |
| Provider Name | Daniel R Harber |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861472714 PECOS PAC ID: 1759337454 Enrollment ID: I20050325000123 |
| Provider Name | Dalya Shamon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164657805 PECOS PAC ID: 4486899903 Enrollment ID: I20130403000409 |
| Provider Name | Sudad L Louis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386804151 PECOS PAC ID: 7618102567 Enrollment ID: I20131030000804 |
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