Halo Primary Care Pllc | |
1535 E State Fair Detroit MI 48203-1257 | |
(313) 891-2740 | |
(313) 731-0213 |
Full Name | Halo Primary Care Pllc |
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Speciality | Clinic/Center |
Location | 1535 E State Fair, Detroit, Michigan |
Authorized Official Name and Position | Mahir Elder (PRESIDENT) |
Authorized Official Contact | 3139937777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Halo Primary Care Pllc 4160 John R St Suite 510 Detroit MI 48201-2020 Ph: (313) 993-7777 | Halo Primary Care Pllc 1535 E State Fair Detroit MI 48203-1257 Ph: (313) 891-2740 |
NPI Number | 1750787784 |
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Provider Enumeration Date | 11/19/2014 |
Last Update Date | 11/19/2014 |
Medicare PECOS PAC ID | 6608274394 |
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Medicare Enrollment ID | O20211011001974 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750787784 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Ribhi Hazin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265747463 PECOS PAC ID: 6901038140 Enrollment ID: I20140422001446 |
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