Morang Chester Clinic P C | |
17520 Chester St Detroit MI 48224-1212 | |
(313) 884-0900 | |
(313) 884-8062 |
Full Name | Morang Chester Clinic P C |
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Speciality | Family Medicine |
Location | 17520 Chester St, Detroit, Michigan |
Authorized Official Name and Position | Barry Braver (PRESIDENT) |
Authorized Official Contact | 3138840900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Morang Chester Clinic P C 17520 Chester St Detroit MI 48224-1212 Ph: (313) 884-0900 | Morang Chester Clinic P C 17520 Chester St Detroit MI 48224-1212 Ph: (313) 884-0900 |
NPI Number | 1497895106 |
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Provider Enumeration Date | 02/08/2007 |
Last Update Date | 06/14/2024 |
Medicare PECOS PAC ID | 4587750047 |
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Medicare Enrollment ID | O20071012000688 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497895106 | NPI | - | NPPES |
0188200304 | Other | MI | BCBSM PIN |
2808979 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5101007774 (Michigan) | Primary |
Provider Name | Barry Braver |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275592412 PECOS PAC ID: 5193715340 Enrollment ID: I20071012000675 |
Provider Name | Tzvi D Braver |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083807176 PECOS PAC ID: 0547458879 Enrollment ID: I20101230000303 |
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