| K & S Family Practice Clinic Pc | |
|
2901 S Newburgh Rd Wayne MI 48184-1001 | |
| (734) 729-7220 | |
| (734) 729-7227 |
| Full Name | K & S Family Practice Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2901 S Newburgh Rd, Wayne, Michigan |
| Authorized Official Name and Position | Suman Patel (OWNER) |
| Authorized Official Contact | 7347297220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K & S Family Practice Clinic Pc 2901 S Newburgh Rd Wayne MI 48184-1001 Ph: (734) 729-7220 | K & S Family Practice Clinic Pc 2901 S Newburgh Rd Wayne MI 48184-1001 Ph: (734) 729-7220 |
| NPI Number | 1023233855 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 06/12/2009 |
| Medicare PECOS PAC ID | 9335197896 |
|---|---|
| Medicare Enrollment ID | O20050111000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023233855 | NPI | - | NPPES |
| 2860306 | Medicaid | MI | |
| E49452 | Other | MI | HAP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | SP406326 (Michigan) | Primary |
| Provider Name | Sumanchandra M Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790773729 PECOS PAC ID: 4587612056 Enrollment ID: I20050112000119 |
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