| Mid Michigan Medicine Pc | |
|
1070 E Caro Rd Caro MI 48723 | |
| (989) 672-2500 | |
| Not Available |
| Full Name | Mid Michigan Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1070 E Caro Rd, Caro, Michigan |
| Authorized Official Name and Position | Farrukh Anwar (OWNER) |
| Authorized Official Contact | 9896722500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Michigan Medicine Pc 1070 E Caro Rd Caro MI 48723-1217 Ph: (989) 672-2500 | Mid Michigan Medicine Pc 1070 E Caro Rd Caro MI 48723 Ph: (989) 672-2500 |
| NPI Number | 1447205307 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 03/30/2021 |
| Medicare PECOS PAC ID | 4981626736 |
|---|---|
| Medicare Enrollment ID | O20051221000605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447205307 | NPI | - | NPPES |
| 4803971 | Medicaid | MI | |
| 4803990 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301071087 (Michigan) | Primary |
| Provider Name | Farrukh Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144268947 PECOS PAC ID: 9638159742 Enrollment ID: I20040721000122 |
| Provider Name | Shahana Farrukh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396790275 PECOS PAC ID: 0143252072 Enrollment ID: I20050831000490 |
| Provider Name | Steven A Holman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851718399 PECOS PAC ID: 0345540134 Enrollment ID: I20151201000656 |
| Provider Name | Jennifer Dinsmoore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023592516 PECOS PAC ID: 6406109941 Enrollment ID: I20181030001646 |
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