| Mini Invasive Orthopedics | |
|
27789 Mound Rd Ste 100 Warren MI 48092-2697 | |
| (313) 209-3353 | |
| (313) 406-7255 |
| Full Name | Mini Invasive Orthopedics |
|---|---|
| Speciality | Clinic/Center |
| Location | 27789 Mound Rd Ste 100, Warren, Michigan |
| Authorized Official Name and Position | Sam Hakki Hackette (OWNER) |
| Authorized Official Contact | 7274224680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mini Invasive Orthopedics Po Box 880 Sterling Heights MI 48311-0880 Ph: (727) 422-4680 | Mini Invasive Orthopedics 27789 Mound Rd Ste 100 Warren MI 48092-2697 Ph: (313) 209-3353 |
| NPI Number | 1467803296 |
|---|---|
| Provider Enumeration Date | 06/22/2016 |
| Last Update Date | 04/30/2021 |
| Medicare PECOS PAC ID | 9739519687 |
|---|---|
| Medicare Enrollment ID | O20200417000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467803296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4301104354 (Michigan) | Primary |
| Provider Name | Sam Hakki Hackette |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043253602 PECOS PAC ID: 7618065509 Enrollment ID: I20140519001008 |
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