| Eastes And Khanukov Md Pc | |
|
15500 19 Mile Rd Suite 360 Clinton Twp MI 48038-6330 | |
| (586) 263-9999 | |
| (586) 263-0581 |
| Full Name | Eastes And Khanukov Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15500 19 Mile Rd, Clinton Twp, Michigan |
| Authorized Official Name and Position | Bryan K Eastes (PRESIDENT) |
| Authorized Official Contact | 5862639999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastes And Khanukov Md Pc 15500 19 Mile Rd Suite 360 Clinton Twp MI 48038-6330 Ph: (586) 263-9999 | Eastes And Khanukov Md Pc 15500 19 Mile Rd Suite 360 Clinton Twp MI 48038-6330 Ph: (586) 263-9999 |
| NPI Number | 1902092273 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 08/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902092273 | NPI | - | NPPES |
| 104223612 | Medicaid | MI | |
| 104223588 | Medicaid | MI | |
| 110E011460 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301048104 (Michigan) | Primary |
| 207R00000X | Internal Medicine | 4301052968 (Michigan) | Secondary |
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