| Mobile Medical Team International | |
|
2603 Electric Ave Ste C Port Huron MI 48060-6588 | |
| (415) 332-2600 | |
| Not Available |
| Full Name | Mobile Medical Team International |
|---|---|
| Speciality | Clinic/Center |
| Location | 2603 Electric Ave Ste C, Port Huron, Michigan |
| Authorized Official Name and Position | Robert Moynihan (INTERIM MEDICAL DIRECTOR) |
| Authorized Official Contact | 9162960495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Medical Team International 111 2nd St Sausalito CA 94965-2526 Ph: (415) 332-2600 | Mobile Medical Team International 2603 Electric Ave Ste C Port Huron MI 48060-6588 Ph: (415) 332-2600 |
| NPI Number | 1558120436 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 08/21/2024 |
| Medicare PECOS PAC ID | 6406296896 |
|---|---|
| Medicare Enrollment ID | O20240502001106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558120436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Naureen A Shaikh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265470173 PECOS PAC ID: 1355391657 Enrollment ID: I20240523001900 |
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