| Clawson Internist Pc | |
|
21 S Main St Clawson MI 48017-2061 | |
| (248) 588-4777 | |
| (248) 588-1241 |
| Full Name | Clawson Internist Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21 S Main St, Clawson, Michigan |
| Authorized Official Name and Position | Niraj Shah (OWNER) |
| Authorized Official Contact | 2485884777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clawson Internist Pc Po Box 1829 Troy MI 48099 Ph: (248) 588-4777 | Clawson Internist Pc 21 S Main St Clawson MI 48017-2061 Ph: (248) 588-4777 |
| NPI Number | 1699859835 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 04/19/2011 |
| Medicare PECOS PAC ID | 2567448780 |
|---|---|
| Medicare Enrollment ID | O20040628001410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699859835 | NPI | - | NPPES |
| 110F323170 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301067271 (Michigan) | Primary |
| 207R00000X | Internal Medicine | 4301057675 (Michigan) | Secondary |
| Provider Name | Hina Doshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508857715 PECOS PAC ID: 5991781114 Enrollment ID: I20040712000494 |
| Provider Name | Niraj Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134119597 PECOS PAC ID: 2264418482 Enrollment ID: I20040712000629 |
| Provider Name | Elizabeth Mary Kreiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538672316 PECOS PAC ID: 8426317009 Enrollment ID: I20180108000964 |
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