| I & L Professional Medical Services | |
|
15357 Farmington Rd Suite 2 Livonia MI 48154-2847 | |
| (734) 266-3565 | |
| Not Available |
| Full Name | I & L Professional Medical Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 15357 Farmington Rd, Livonia, Michigan |
| Authorized Official Name and Position | Innocent E. Agbassi (PRESIDENT) |
| Authorized Official Contact | 3132824527 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I & L Professional Medical Services 15357 Farmington Rd Suite 2 Livonia MI 48154-2847 Ph: () - | I & L Professional Medical Services 15357 Farmington Rd Suite 2 Livonia MI 48154-2847 Ph: (734) 266-3565 |
| NPI Number | 1760409593 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 06/17/2016 |
| Medicare PECOS PAC ID | 1658375357 |
|---|---|
| Medicare Enrollment ID | O20060912000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760409593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301075373 (Michigan) | Primary |
| Provider Name | Innocent Egwuatu Agbassi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922053636 PECOS PAC ID: 3577593292 Enrollment ID: I20050812000652 |
| Provider Name | Lawanda H Agbassi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083638993 PECOS PAC ID: 1557365251 Enrollment ID: I20150729007091 |
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