| Louis D Soverinsky D.o. Pllc | |
|
1701 Baldwin Ave Suite 203 Pontiac MI 48340-3412 | |
| (248) 334-2311 | |
| (248) 334-6738 |
| Full Name | Louis D Soverinsky D.o. Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1701 Baldwin Ave, Pontiac, Michigan |
| Authorized Official Name and Position | Louis Donald Soverinsky (OWNER) |
| Authorized Official Contact | 2483342311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis D Soverinsky D.o. Pllc 1701 Baldwin Ave Suite 203 Pontiac MI 48340-3412 Ph: (248) 334-2311 | Louis D Soverinsky D.o. Pllc 1701 Baldwin Ave Suite 203 Pontiac MI 48340-3412 Ph: (248) 334-2311 |
| NPI Number | 1912237512 |
|---|---|
| Provider Enumeration Date | 01/04/2010 |
| Last Update Date | 01/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912237512 | NPI | - | NPPES |
| 4094758 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5101005076 (Michigan) | Primary |
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