| Henry Ford West Bloomfield Physicians | |
|
6777 W Maple Rd West Bloomfield MI 48322-3013 | |
| (248) 325-1000 | |
| Not Available |
| Full Name | Henry Ford West Bloomfield Physicians |
|---|---|
| Speciality | General Practice |
| Location | 6777 W Maple Rd, West Bloomfield, Michigan |
| Authorized Official Name and Position | Brian Gamble (CFO) |
| Authorized Official Contact | 2483251000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry Ford West Bloomfield Physicians Po Box 674852 Detroit MI 48267-4852 Ph: () - | Henry Ford West Bloomfield Physicians 6777 W Maple Rd West Bloomfield MI 48322-3013 Ph: (248) 325-1000 |
| NPI Number | 1215333976 |
|---|---|
| Provider Enumeration Date | 11/07/2014 |
| Last Update Date | 11/11/2014 |
| Medicare PECOS PAC ID | 1951626399 |
|---|---|
| Medicare Enrollment ID | O20150206000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215333976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Frank L Fenton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215081211 PECOS PAC ID: 8123012879 Enrollment ID: I20081009000296 |
| Provider Name | Mark P Karchon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699861088 PECOS PAC ID: 7315912417 Enrollment ID: I20090615000345 |
| Provider Name | Michael J Feldman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194091066 PECOS PAC ID: 5395960496 Enrollment ID: I20170817004276 |
| Provider Name | Tassia M Samona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891175048 PECOS PAC ID: 6901159342 Enrollment ID: I20181031002825 |
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