Dean Clinic, P.c. | |
4140 E 8 Mile Rd Detroit MI 48234-1014 | |
(313) 366-9502 | |
(313) 366-9503 |
Full Name | Dean Clinic, P.c. |
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Speciality | Clinic/Center |
Location | 4140 E 8 Mile Rd, Detroit, Michigan |
Authorized Official Name and Position | Roger Stanley Harris (PRESIDENT) |
Authorized Official Contact | 3133669502 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dean Clinic, P.c. 4140 E 8 Mile Rd Detroit MI 48234-1014 Ph: (313) 366-9502 | Dean Clinic, P.c. 4140 E 8 Mile Rd Detroit MI 48234-1014 Ph: (313) 366-9502 |
NPI Number | 1942357959 |
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Provider Enumeration Date | 01/04/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 1951432137 |
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Medicare Enrollment ID | O20100702000128 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942357959 | NPI | - | NPPES |
1371362 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (Michigan) | Primary |
Provider Name | Roger S Harris |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730188269 PECOS PAC ID: 9234031378 Enrollment ID: I20040121000325 |
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