| My Family Doctor | |
|
12100 Dix Toledo Rd Southgate MI 48195-3531 | |
| (734) 282-5502 | |
| (734) 282-7106 |
| Full Name | My Family Doctor |
|---|---|
| Speciality | Family Medicine |
| Location | 12100 Dix Toledo Rd, Southgate, Michigan |
| Authorized Official Name and Position | Michael L Gambel (OWNER/PRESIDENT) |
| Authorized Official Contact | 7342825502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Family Doctor 12100 Dix Toledo Rd Southgate MI 48195-3531 Ph: (734) 282-5502 | My Family Doctor 12100 Dix Toledo Rd Southgate MI 48195-3531 Ph: (734) 282-5502 |
| NPI Number | 1942458567 |
|---|---|
| Provider Enumeration Date | 09/08/2008 |
| Last Update Date | 04/08/2011 |
| Medicare PECOS PAC ID | 6507992492 |
|---|---|
| Medicare Enrollment ID | O20100330001051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942458567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301042047 (* (Not Available)) | Primary |
| Provider Name | Cindy Clare Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447859731 PECOS PAC ID: 2163837550 Enrollment ID: I20210303002316 |
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