| Forum Medical Clinic, Pc | |
|
43184 Dequindre Rd Ste 202 Sterling Heights MI 48314-1709 | |
| (586) 580-0280 | |
| (586) 580-0281 |
| Full Name | Forum Medical Clinic, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 43184 Dequindre Rd Ste 202, Sterling Heights, Michigan |
| Authorized Official Name and Position | Nicolas A Marsheh (OWNER/OPERATOR) |
| Authorized Official Contact | 5865800280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forum Medical Clinic, Pc 43184 Dequindre Rd Ste 202 Sterling Heights MI 48314-1709 Ph: (586) 580-0280 | Forum Medical Clinic, Pc 43184 Dequindre Rd Ste 202 Sterling Heights MI 48314-1709 Ph: (586) 580-0280 |
| NPI Number | 1992734578 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 5991723876 |
|---|---|
| Medicare Enrollment ID | O20051109000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992734578 | NPI | - | NPPES |
| 0E00984 | Other | MI | BCBS |
| 1106348002 | Other | MI | BCBSM |
| 4732824 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | NM 069838 (Michigan) | Primary |
| Provider Name | Sami E Asmar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861466500 PECOS PAC ID: 3072401728 Enrollment ID: I20040323001157 |
| Provider Name | Nicolas A Marsheh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962423657 PECOS PAC ID: 1951367069 Enrollment ID: I20041209000384 |
| Provider Name | Rita A Sahakian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790139251 PECOS PAC ID: 7517258478 Enrollment ID: I20160623001139 |
| Provider Name | Carla R Benavides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891246088 PECOS PAC ID: 7416237102 Enrollment ID: I20161215001582 |
| Provider Name | Soodad Rabban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710348503 PECOS PAC ID: 0840577268 Enrollment ID: I20170511001691 |
| Provider Name | Shannon M Ouimet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386206431 PECOS PAC ID: 6002146446 Enrollment ID: I20190926002969 |
| Provider Name | Amanda Marie Gough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316419609 PECOS PAC ID: 7517392236 Enrollment ID: I20200127000644 |
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