| Medicina Scarlett Llc | |
|
8631 W Vernor Hwy Ste B1a Detroit MI 48209-3420 | |
| (917) 885-5670 | |
| Not Available |
| Full Name | Medicina Scarlett Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8631 W Vernor Hwy Ste B1a, Detroit, Michigan |
| Authorized Official Name and Position | Scarlett Idema (FAMILY NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 9178855670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicina Scarlett Llc 2932 Elmhurst Ave Royal Oak MI 48073-3099 Ph: (917) 885-5670 | Medicina Scarlett Llc 8631 W Vernor Hwy Ste B1a Detroit MI 48209-3420 Ph: (917) 885-5670 |
| NPI Number | 1912602285 |
|---|---|
| Provider Enumeration Date | 04/04/2023 |
| Last Update Date | 06/23/2023 |
| Medicare PECOS PAC ID | 9830559202 |
|---|---|
| Medicare Enrollment ID | O20230717002502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912602285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Scarlett Idema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316520653 PECOS PAC ID: 8325443849 Enrollment ID: I20210823000261 |
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