| Court Street Family Medicine | |
|
G4007 W Court St Suite B Flint MI 48532-3560 | |
| (810) 732-7716 | |
| (810) 732-7863 |
| Full Name | Court Street Family Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | G4007 W Court St, Flint, Michigan |
| Authorized Official Name and Position | Shafi J Ahmed (OWNER PRESIDENT) |
| Authorized Official Contact | 8107327716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Court Street Family Medicine G4007 W Court St Suite B Flint MI 48532-3560 Ph: (810) 732-7716 | Court Street Family Medicine G4007 W Court St Suite B Flint MI 48532-3560 Ph: (810) 732-7716 |
| NPI Number | 1730276981 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 06/22/2011 |
| Medicare PECOS PAC ID | 1658471222 |
|---|---|
| Medicare Enrollment ID | O20070711000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730276981 | NPI | - | NPPES |
| 080B512470 | Other | MI | BLUE CROSS BLUE SHIELD |
| 3331400 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301023712 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 4301056194 (Michigan) | Primary |
| Provider Name | Shafi J Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326121823 PECOS PAC ID: 0244223212 Enrollment ID: I20040406000381 |
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