Elisa B Picken, Md, Pllc | |
3053 Miller Rd Ann Arbor MI 48103-2122 | |
(734) 547-3990 | |
Not Available |
Full Name | Elisa B Picken, Md, Pllc |
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Speciality | Family Medicine |
Location | 3053 Miller Rd, Ann Arbor, Michigan |
Authorized Official Name and Position | Elisa B Picken (MEMBER) |
Authorized Official Contact | 7345473990 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elisa B Picken, Md, Pllc 3053 Miller Rd Ann Arbor MI 48103-2122 Ph: () - | Elisa B Picken, Md, Pllc 3053 Miller Rd Ann Arbor MI 48103-2122 Ph: (734) 547-3990 |
NPI Number | 1598110959 |
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Provider Enumeration Date | 05/03/2016 |
Last Update Date | 05/03/2016 |
Medicare PECOS PAC ID | 4688942519 |
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Medicare Enrollment ID | O20170619001989 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598110959 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301082194 (Michigan) | Primary |
Provider Name | Elisa B Picken |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669591079 PECOS PAC ID: 2365536745 Enrollment ID: I20070915000225 |
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