| |
23003 Greater Mack Ave Ste. A St. Clair Shores MI 48080 | |
(586) 779-6830 | |
Not Available |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 23003 Greater Mack Ave, St. Clair Shores, Michigan |
Authorized Official Name and Position | Alex Olkhovsky (V.P.) |
Authorized Official Contact | 5867723403 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
23003 Greater Mack Ave Ste. A St. Clair Shores MI 48080 Ph: (586) 779-6830 | 23003 Greater Mack Ave Ste. A St. Clair Shores MI 48080 Ph: (586) 779-6830 |
NPI Number | 1780656074 |
---|---|
Provider Enumeration Date | 02/02/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780656074 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Doctors Clinic P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21611 East Eleven Mile Road, St. Clair Shores, MI 48081 Phone: 586-771-7200 | |