| Michigan Moonlighters Pllc | |
|
44405 Woodward Ave Pontiac MI 48341-5023 | |
| (248) 858-3000 | |
| (248) 627-8884 |
| Full Name | Michigan Moonlighters Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 44405 Woodward Ave, Pontiac, Michigan |
| Authorized Official Name and Position | Rajinder Grewal (PRESIDENT) |
| Authorized Official Contact | 2486278881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Moonlighters Pllc 3700 Piccadilly Dr Rochester Hills MI 48309-4536 Ph: (248) 627-8881 | Michigan Moonlighters Pllc 44405 Woodward Ave Pontiac MI 48341-5023 Ph: (248) 858-3000 |
| NPI Number | 1174178420 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 4082943139 |
|---|---|
| Medicare Enrollment ID | O20190916000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174178420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rajinder S Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437327350 PECOS PAC ID: 0345389391 Enrollment ID: I20091203000617 |
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