Gaps Health In P.c. | |
5319 Betheny Cir Superior Twp MI 48198-9653 | |
(682) 206-3118 | |
Not Available |
Full Name | Gaps Health In P.c. |
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Speciality | General Practice |
Location | 5319 Betheny Cir, Superior Twp, Michigan |
Authorized Official Name and Position | Jody Hunter (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 7348120996 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gaps Health In P.c. 5319 Betheny Cir Superior Twp MI 48198-9653 Ph: (682) 206-3118 | Gaps Health In P.c. 5319 Betheny Cir Superior Twp MI 48198-9653 Ph: (682) 206-3118 |
NPI Number | 1851913719 |
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Provider Enumeration Date | 05/14/2020 |
Last Update Date | 05/14/2020 |
Medicare PECOS PAC ID | 8729404397 |
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Medicare Enrollment ID | O20200812003994 |
Identifier | Type | State | Issuer |
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1851913719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Roland Pua |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215009782 PECOS PAC ID: 2961403035 Enrollment ID: I20070117000107 |
Mohammad Nadeemullah Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5400 Waldenhill Ct, Superior Twp, MI 48198 Phone: 734-972-3692 Fax: 734-761-8787 |