| Nova Medica Pllc | |
|
20331 Farmington Rd Livonia MI 48152-1411 | |
| (248) 478-1100 | |
| (248) 478-7054 |
| Full Name | Nova Medica Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 20331 Farmington Rd, Livonia, Michigan |
| Authorized Official Name and Position | Nasser Taghavi (DOCTOR/OWNER) |
| Authorized Official Contact | 2484781100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Medica Pllc 20331 Farmington Rd Livonia MI 48152-1411 Ph: (248) 478-1100 | Nova Medica Pllc 20331 Farmington Rd Livonia MI 48152-1411 Ph: (248) 478-1100 |
| NPI Number | 1417979360 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 07/16/2010 |
| Medicare PECOS PAC ID | 6901938489 |
|---|---|
| Medicare Enrollment ID | O20100719000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417979360 | NPI | - | NPPES |
| 4334184 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | NT060867 (Michigan) | Primary |
| Provider Name | Stephen E Kronberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528071818 PECOS PAC ID: 5597869065 Enrollment ID: I20070323000086 |
| Provider Name | Nasser Taghavi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487624383 PECOS PAC ID: 0446350953 Enrollment ID: I20070713000054 |
| Provider Name | Shahzad S Qureshi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558588582 PECOS PAC ID: 8022184688 Enrollment ID: I20080904000565 |
| Provider Name | Robert S Ciemiega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770692907 PECOS PAC ID: 4486819133 Enrollment ID: I20120629000532 |
| Provider Name | Bridget E Przybyla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326387788 PECOS PAC ID: 3971734930 Enrollment ID: I20140317000810 |
| Provider Name | Mark Louis Passow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871908897 PECOS PAC ID: 7719273028 Enrollment ID: I20160913002713 |
| Provider Name | Siham H Ferdaous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265916514 PECOS PAC ID: 0648696807 Enrollment ID: I20200818003029 |
| Provider Name | Patricia C Keckan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356918429 PECOS PAC ID: 0446640478 Enrollment ID: I20211207001768 |
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