| Birmingham Medical Pllc | |
|
180 E Brown St Birmingham MI 48009-6237 | |
| (248) 645-1000 | |
| Not Available |
| Full Name | Birmingham Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 180 E Brown St, Birmingham, Michigan |
| Authorized Official Name and Position | Lyle Scott Grant (OWNER) |
| Authorized Official Contact | 2486451000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Birmingham Medical Pllc 180 E Brown St Birmingham MI 48009-6237 Ph: (248) 645-1000 | Birmingham Medical Pllc 180 E Brown St Birmingham MI 48009-6237 Ph: (248) 645-1000 |
| NPI Number | 1982806782 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3870774730 |
|---|---|
| Medicare Enrollment ID | O20110224000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982806782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lyle S Grant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033214697 PECOS PAC ID: 1850572710 Enrollment ID: I20110224000886 |
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