| Eastside Internal Medicine Pc | |
|
28315 Harper Ave Saint Clair Shores MI 48081-1687 | |
| (586) 552-1710 | |
| (586) 552-1715 |
| Full Name | Eastside Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 28315 Harper Ave, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Lori Eckenwiler (OFFICE MANAGER) |
| Authorized Official Contact | 5865521710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Internal Medicine Pc 28315 Harper Ave Saint Clair Shores MI 48081-1687 Ph: (586) 552-1710 | Eastside Internal Medicine Pc 28315 Harper Ave Saint Clair Shores MI 48081-1687 Ph: (586) 552-1710 |
| NPI Number | 1831201821 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/21/2011 |
| Medicare PECOS PAC ID | 5496854713 |
|---|---|
| Medicare Enrollment ID | O20070627000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831201821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301049083 (Michigan) | Primary |
| Provider Name | Muna A Beeai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689676215 PECOS PAC ID: 8325037138 Enrollment ID: I20040507000728 |
| Provider Name | Stephen Paul Daddario |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821006784 PECOS PAC ID: 0941309264 Enrollment ID: I20100520000796 |
| Provider Name | Eric Neisch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225046477 PECOS PAC ID: 1850490178 Enrollment ID: I20100520000872 |
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