| Canton Family Medicine And Medical Spa, Pllc | |
|
5958 N Canton Center Rd Suite 200 Canton MI 48187-2765 | |
| (734) 667-1648 | |
| (734) 667-1649 |
| Full Name | Canton Family Medicine And Medical Spa, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5958 N Canton Center Rd, Canton, Michigan |
| Authorized Official Name and Position | Miguel Granados (PHYSICIAN OWNER) |
| Authorized Official Contact | 7346671648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Family Medicine And Medical Spa, Pllc 5958 N Canton Center Rd Suite 200 Canton MI 48187-2765 Ph: (734) 667-1648 | Canton Family Medicine And Medical Spa, Pllc 5958 N Canton Center Rd Suite 200 Canton MI 48187-2765 Ph: (734) 667-1648 |
| NPI Number | 1386081529 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 01/10/2017 |
| Medicare PECOS PAC ID | 7214170133 |
|---|---|
| Medicare Enrollment ID | O20130826000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386081529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301061850 (Michigan) | Primary |
| Provider Name | Miguel Granados |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043283286 PECOS PAC ID: 5698759264 Enrollment ID: I20040614000645 |
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