| 365 Health Care Group Plc | |
|
22711 Grand River Ave Detroit MI 48219-3113 | |
| (888) 402-0202 | |
| (888) 860-2960 |
| Full Name | 365 Health Care Group Plc |
|---|---|
| Speciality | Surgery |
| Location | 22711 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Kimberly Miller (DIRECTOR OF RCM) |
| Authorized Official Contact | 2483317908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 365 Health Care Group Plc Po Box 83252 Chicago IL 60691-0252 Ph: (888) 402-0202 | 365 Health Care Group Plc 22711 Grand River Ave Detroit MI 48219-3113 Ph: (888) 402-0202 |
| NPI Number | 1750855086 |
|---|---|
| Provider Enumeration Date | 01/21/2019 |
| Last Update Date | 10/18/2024 |
| Medicare PECOS PAC ID | 6305186685 |
|---|---|
| Medicare Enrollment ID | O20190323000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750855086 | NPI | - | NPPES |
| Provider Name | Karl O Bandlien |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831205517 PECOS PAC ID: 0941292320 Enrollment ID: I20040402001252 |
| Provider Name | Syed Karim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497853634 PECOS PAC ID: 2567451966 Enrollment ID: I20040511000342 |
| Provider Name | Michael A Hartman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578676847 PECOS PAC ID: 6002986262 Enrollment ID: I20080530000783 |
| Provider Name | Matthew D Andrews |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326317785 PECOS PAC ID: 4789837279 Enrollment ID: I20130111000466 |
| Provider Name | Dominic Antonio Atiyeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306368527 PECOS PAC ID: 5597012864 Enrollment ID: I20200618000616 |
| Provider Name | Ayeza Mohsin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619235264 PECOS PAC ID: 4385948942 Enrollment ID: I20240323000465 |
| Provider Name | Saad Mohsin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043754310 PECOS PAC ID: 8426339656 Enrollment ID: I20240329001954 |
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