Innovation Medicine, Pllc | |
25710 Kelly Rd Ste 3 Roseville MI 48066-4959 | |
(586) 772-2600 | |
Not Available |
Full Name | Innovation Medicine, Pllc |
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Speciality | Internal Medicine |
Location | 25710 Kelly Rd, Roseville, Michigan |
Authorized Official Name and Position | Basem Almasri (PHYSICIAN) |
Authorized Official Contact | 5867722600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Innovation Medicine, Pllc 25710 Kelly Rd Ste 3 Roseville MI 48066-4959 Ph: () - | Innovation Medicine, Pllc 25710 Kelly Rd Ste 3 Roseville MI 48066-4959 Ph: (586) 772-2600 |
NPI Number | 1720511405 |
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Provider Enumeration Date | 04/10/2017 |
Last Update Date | 12/12/2023 |
Medicare PECOS PAC ID | 9537446497 |
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Medicare Enrollment ID | O20170501002208 |
Identifier | Type | State | Issuer |
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1720511405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
Provider Name | Basem Almasri |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326040510 PECOS PAC ID: 5698677284 Enrollment ID: I20040123000597 |
Provider Name | Rudy Jerome Vervaeke |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922108927 PECOS PAC ID: 6800886433 Enrollment ID: I20040515000418 |
Provider Name | Osama Nicola Nunu |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831191170 PECOS PAC ID: 6507893070 Enrollment ID: I20050726001036 |
Provider Name | Borivoje M Trifunovic |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730167644 PECOS PAC ID: 6507899671 Enrollment ID: I20050919000293 |
Provider Name | Susanne Garay |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952867905 PECOS PAC ID: 9739429358 Enrollment ID: I20190319000680 |
Provider Name | Bryce A Bowers |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689233470 PECOS PAC ID: 3577959733 Enrollment ID: I20220415000828 |
Provider Name | Aaron N Achatz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194580191 PECOS PAC ID: 2062850746 Enrollment ID: I20240401000260 |
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