| Halo Primary Care | |
|
1535 E State Fair Detroit MI 48203-1257 | |
| (313) 891-2740 | |
| Not Available |
| Full Name | Halo Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1535 E State Fair, Detroit, Michigan |
| Authorized Official Name and Position | Hanady Beydoun (OFFICE MANAGER) |
| Authorized Official Contact | 3139937777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halo Primary Care 22720 Michigan Ave Ste 200 Dearborn MI 48124-2021 Ph: (313) 891-2740 | Halo Primary Care 1535 E State Fair Detroit MI 48203-1257 Ph: (313) 891-2740 |
| NPI Number | 1386101293 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 03/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386101293 | NPI | - | NPPES |
| 14264493 | Other | CAQH | |
| 12715957 | Other | CAQH | |
| 1417245721 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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