| Dr. J. Thwainey Md Pc | |
|
7106 Park Ave Allen Park MI 48101-2038 | |
| (313) 383-8310 | |
| (313) 383-2756 |
| Full Name | Dr. J. Thwainey Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7106 Park Ave, Allen Park, Michigan |
| Authorized Official Name and Position | Jalal Thwainey (OWNER) |
| Authorized Official Contact | 3133838310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. J. Thwainey Md Pc 7106 Park Ave Allen Park MI 48101-2038 Ph: (313) 383-8310 | Dr. J. Thwainey Md Pc 7106 Park Ave Allen Park MI 48101-2038 Ph: (313) 383-8310 |
| NPI Number | 1962694661 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 12/18/2020 |
| Medicare PECOS PAC ID | 1658380498 |
|---|---|
| Medicare Enrollment ID | O20060406000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962694661 | NPI | - | NPPES |
| 104843672 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301047446 (Michigan) | Primary |
| 208D00000X | General Practice | 4301047446 (Michigan) | Secondary |
| Provider Name | Jalal J Thwainey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568432441 PECOS PAC ID: 6901815745 Enrollment ID: I20060410000138 |
| Provider Name | Bassam Jabrail Thwainey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871821389 PECOS PAC ID: 8820123177 Enrollment ID: I20100312000035 |
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