Avalon Physician Services | |
21800 Haggerty Rd Ste 113 Northville MI 48167-9051 | |
(888) 882-3783 | |
(888) 667-3531 |
Full Name | Avalon Physician Services |
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Speciality | Family Medicine |
Location | 21800 Haggerty Rd Ste 113, Northville, Michigan |
Authorized Official Name and Position | Gary P Sarafa (PRINCIPAL) |
Authorized Official Contact | 2488844279 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Avalon Physician Services 21800 Haggerty Rd Ste 113 Northville MI 48167-9051 Ph: (888) 882-3783 | Avalon Physician Services 21800 Haggerty Rd Ste 113 Northville MI 48167-9051 Ph: (888) 882-3783 |
NPI Number | 1265859920 |
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Provider Enumeration Date | 03/19/2014 |
Last Update Date | 10/11/2017 |
Medicare PECOS PAC ID | 3072736511 |
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Medicare Enrollment ID | O20140602000577 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265859920 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christine S Shina |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1558457994 PECOS PAC ID: 9638176613 Enrollment ID: I20061106000115 |
Provider Name | Gary P Sarafa |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1174697684 PECOS PAC ID: 7315004090 Enrollment ID: I20090325000034 |
Provider Name | Joan M Moccia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528365889 PECOS PAC ID: 1254519069 Enrollment ID: I20110627000525 |
Provider Name | Michelle C Dolson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598048464 PECOS PAC ID: 5799933131 Enrollment ID: I20120910000825 |
Provider Name | Maureen Romanchik |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881032407 PECOS PAC ID: 2567693286 Enrollment ID: I20140322000241 |
Provider Name | Andrew Steven White |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407232879 PECOS PAC ID: 0840591194 Enrollment ID: I20151210002598 |
Provider Name | Laura Sheri Kremer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376055723 PECOS PAC ID: 8729344148 Enrollment ID: I20171116003241 |
Provider Name | Andrew Paul Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477904134 PECOS PAC ID: 9436432291 Enrollment ID: I20180813000494 |
Provider Name | Amanda S Courneya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386104248 PECOS PAC ID: 8628319860 Enrollment ID: I20190416001581 |
Provider Name | Sheree Lynn Slack |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154968279 PECOS PAC ID: 8628406220 Enrollment ID: I20200313000990 |
Provider Name | Laura Sheri Kremer |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1376055723 PECOS PAC ID: 8729344148 Enrollment ID: I20201020002518 |
Provider Name | Breana Strong |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184206658 PECOS PAC ID: 8820490659 Enrollment ID: I20210715001787 |
Provider Name | Karen E Genter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790407260 PECOS PAC ID: 5991179236 Enrollment ID: I20230328000976 |
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