Dearborn Primary Care, P.c. | |
22260 Garrison St Dearborn MI 48124-2208 | |
(313) 562-9128 | |
(313) 562-1020 |
Full Name | Dearborn Primary Care, P.c. |
---|---|
Speciality | Internal Medicine |
Location | 22260 Garrison St, Dearborn, Michigan |
Authorized Official Name and Position | Ranajit Mukherjee (PWNER) |
Authorized Official Contact | 3135629128 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dearborn Primary Care, P.c. 22260 Garrison St Dearborn MI 48124-2208 Ph: (313) 562-9128 | Dearborn Primary Care, P.c. 22260 Garrison St Dearborn MI 48124-2208 Ph: (313) 562-9128 |
NPI Number | 1316362999 |
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Provider Enumeration Date | 02/19/2014 |
Last Update Date | 02/19/2014 |
Medicare PECOS PAC ID | 1456638295 |
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Medicare Enrollment ID | O20170504002229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316362999 | NPI | - | NPPES |
4301060584 | Other | MI | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301060584 (Michigan) | Primary |
Provider Name | William I Michels |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295722171 PECOS PAC ID: 7618163239 Enrollment ID: I20101122001076 |
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