Michigan Internal Medicine Center Pc | |
928 Bloomfield Knoll Dr Bloomfield Hills MI 48304-2015 | |
(248) 761-5185 | |
Not Available |
Full Name | Michigan Internal Medicine Center Pc |
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Speciality | Internal Medicine |
Location | 928 Bloomfield Knoll Dr, Bloomfield Hills, Michigan |
Authorized Official Name and Position | Kathleen M Nadai (BILLING AGENT) |
Authorized Official Contact | 2485473914 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Michigan Internal Medicine Center Pc 928 Bloomfield Knoll Dr Bloomfield Hills MI 48304-2015 Ph: (248) 761-5185 | Michigan Internal Medicine Center Pc 928 Bloomfield Knoll Dr Bloomfield Hills MI 48304-2015 Ph: (248) 761-5185 |
NPI Number | 1871777672 |
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Provider Enumeration Date | 12/28/2007 |
Last Update Date | 01/24/2018 |
Medicare PECOS PAC ID | 2466415088 |
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Medicare Enrollment ID | O20041104001108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871777672 | NPI | - | NPPES |
104702923 | Medicaid | MI | |
1106304251 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301075318 (Michigan) | Primary |
Provider Name | Shaileshkumar K Desai |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225046220 PECOS PAC ID: 9638132251 Enrollment ID: I20041112000711 |
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