| Genaspire Llc | |
|
9400 Red Maple Ct Plymouth MI 48170-6328 | |
| (734) 526-3600 | |
| (734) 526-3626 |
| Full Name | Genaspire Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9400 Red Maple Ct, Plymouth, Michigan |
| Authorized Official Name and Position | Melissa Miller (OWNER) |
| Authorized Official Contact | 7328125504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genaspire Llc 9400 Red Maple Ct Plymouth MI 48170-6328 Ph: (734) 526-3600 | Genaspire Llc 9400 Red Maple Ct Plymouth MI 48170-6328 Ph: (734) 526-3600 |
| NPI Number | 1245997576 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Medicare PECOS PAC ID | 4385034131 |
|---|---|
| Medicare Enrollment ID | O20211209001289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245997576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Melissa Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275196651 PECOS PAC ID: 7012244643 Enrollment ID: I20190806000324 |
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