Bay Pc Prime Medical | |
210 Forest Park Cir Panama City FL 32405-4915 | |
(850) 872-0332 | |
(850) 769-7717 |
Full Name | Bay Pc Prime Medical |
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Speciality | Internal Medicine |
Location | 210 Forest Park Cir, Panama City, Florida |
Authorized Official Name and Position | Mohamed Kassem (PRESIDENT) |
Authorized Official Contact | 8508720332 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bay Pc Prime Medical Po Box 922 Panama City FL 32402-0922 Ph: (850) 872-0332 | Bay Pc Prime Medical 210 Forest Park Cir Panama City FL 32405-4915 Ph: (850) 872-0332 |
NPI Number | 1649631235 |
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Provider Enumeration Date | 03/10/2016 |
Last Update Date | 03/10/2016 |
Medicare PECOS PAC ID | 8527357789 |
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Medicare Enrollment ID | O20160512000147 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649631235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME91546 (Florida) | Primary |
Provider Name | Mohamed K Kassem |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528027356 PECOS PAC ID: 9234195801 Enrollment ID: I20041206000424 |
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