East Park Medical Center | |
4821 Mcnichols St Detroit MI 48212-1730 | |
(313) 368-4600 | |
(313) 368-4700 |
Full Name | East Park Medical Center |
---|---|
Speciality | Family Medicine |
Location | 4821 Mcnichols St, Detroit, Michigan |
Authorized Official Name and Position | Sai Wentum (CEO) |
Authorized Official Contact | 3133684600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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East Park Medical Center 4821 Mcnichols St Detroit MI 48212-1730 Ph: (313) 368-4600 | East Park Medical Center 4821 Mcnichols St Detroit MI 48212-1730 Ph: (313) 368-4600 |
NPI Number | 1053462846 |
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Provider Enumeration Date | 01/16/2007 |
Last Update Date | 05/20/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053462846 | NPI | - | NPPES |
4529149 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 049430 (Michigan) | Primary |
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