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1622 Sherwood Ct Dearborn MI 48124-4073 | |
| (313) 929-0007 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1622 Sherwood Ct, Dearborn, Michigan |
| Authorized Official Name and Position | Christine Michalik (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2486632021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1622 Sherwood Ct Dearborn MI 48124-4073 Ph: () - | 1622 Sherwood Ct Dearborn MI 48124-4073 Ph: (313) 929-0007 |
| NPI Number | 1629848957 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 02/01/2024 |
| Medicare PECOS PAC ID | 2567723885 |
|---|---|
| Medicare Enrollment ID | O20180301002396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629848957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary K Hunsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164436119 PECOS PAC ID: 7618975038 Enrollment ID: I20061120000302 |
| Provider Name | Mohammad Saleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619394004 PECOS PAC ID: 3779892500 Enrollment ID: I20171005002314 |
| Provider Name | Nadia Piccolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205451259 PECOS PAC ID: 9830508043 Enrollment ID: I20210429000394 |
| Provider Name | Mackenzie Brooke Pung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376320424 PECOS PAC ID: 0749639763 Enrollment ID: I20231215000172 |
| Provider Name | Abed Naji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700647617 PECOS PAC ID: 1850734864 Enrollment ID: I20240207000351 |
| Provider Name | Ali A Jishi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922673342 PECOS PAC ID: 0143668939 Enrollment ID: I20240328003267 |
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