| Genesee Family Care Pc | |
|
3020 South Genesee Rd Burton MI 48519 | |
| (810) 715-3049 | |
| (810) 744-2850 |
| Full Name | Genesee Family Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3020 South Genesee Rd, Burton, Michigan |
| Authorized Official Name and Position | Jose B Lopez (PHYSICIAN) |
| Authorized Official Contact | 8107153049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesee Family Care Pc 3020 South Genesee Rd Burton MI 48519 Ph: (810) 715-3049 | Genesee Family Care Pc 3020 South Genesee Rd Burton MI 48519 Ph: (810) 715-3049 |
| NPI Number | 1538222823 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 02/09/2010 |
| Medicare PECOS PAC ID | 9436165826 |
|---|---|
| Medicare Enrollment ID | O20060222000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538222823 | NPI | - | NPPES |
| 080B500140 | Other | MI | B CR |
| 2621432 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | JL047858 (Michigan) | Primary |
| 207Q00000X | Family Medicine | MO079826 (Michigan) | Secondary |
| Provider Name | Jose B Lopez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154305241 PECOS PAC ID: 7517973902 Enrollment ID: I20060329000335 |
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