| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 816 Joslyn, Pontiac, Michigan |
| Authorized Official Name and Position | Lloyd Kernen (CFO-INTERIM CEO) |
| Authorized Official Contact | 2487247411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
P.o. Box 430150 Pontiac MI 48343 Ph: (248) 724-7600 | 816 Joslyn Pontiac MI 48340 Ph: (248) 758-1231 |
| NPI Number | 1558629238 |
|---|---|
| Provider Enumeration Date | 05/01/2012 |
| Last Update Date | 06/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558629238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Michigan) | Primary |
Grace Pediatrics Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44200 Woodward Ave Ste 103, Pontiac, MI 48341 Phone: 248-253-9600 Fax: 248-253-0980 | |
Oakland Progressive Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 461 W Huron St, Suite 600, Seminole Building, Pontiac, MI 48341 Phone: 248-857-7500 | |
Oakland Physicians Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 461 W Huron St, Pontiac, MI 48341 Phone: 248-857-7583 | |
A.w.c. Fairclough Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 989 University Dr, Suite 107, Pontiac, MI 48342 Phone: 248-334-4773 Fax: 248-334-8230 | |
Oakland Primary Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 46 N Saginaw St, Pontiac, MI 48342 Phone: 248-322-6747 Fax: 248-322-5787 | |