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45445 Mound Rd Ste 105 Shelby Township MI 48317-5178 | |
(866) 207-5105 | |
(248) 282-1313 |
Full Name | |
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Speciality | Internal Medicine |
Location | 45445 Mound Rd Ste 105, Shelby Township, Michigan |
Authorized Official Name and Position | Steve Kallabat (OWNER) |
Authorized Official Contact | 2489393777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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45445 Mound Rd Ste 105 Shelby Township MI 48317-5178 Ph: (866) 207-5105 | 45445 Mound Rd Ste 105 Shelby Township MI 48317-5178 Ph: (866) 207-5105 |
NPI Number | 1831717842 |
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Provider Enumeration Date | 07/07/2020 |
Last Update Date | 01/24/2023 |
Medicare PECOS PAC ID | 4587919055 |
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Medicare Enrollment ID | O20200702000661 |
Identifier | Type | State | Issuer |
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1831717842 | NPI | - | NPPES |
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