Mrs Tia Dominique Agboruche, | |
20418 Binder St, Detroit, MI 48234-1913 | |
(313) 333-4038 | |
Not Available |
Full Name | Mrs Tia Dominique Agboruche |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 3 Years |
Location | 20418 Binder St, Detroit, Michigan |
Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013687029 | NPI | - | NPPES |
Facility Name | Location | Facility Type |
---|---|---|
Beaumont Hospital Royal Oak | Royal oak, MI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northstar Anesthesia Of Michigan Iii Pllc | 7911325469 | 510 |
Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972126209 PECOS PAC ID: 7911325469 Enrollment ID: O20200915001990 |
Mailing Address | Practice Location Address |
---|---|
Mrs Tia Dominique Agboruche, 20418 Binder St, Detroit, MI 48234-1913 Ph: (313) 333-4038 | Mrs Tia Dominique Agboruche, 20418 Binder St, Detroit, MI 48234-1913 Ph: (313) 333-4038 |
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