| Park Medical Centers | |
|
12871 E Jefferson Ave Detroit MI 48215-2754 | |
| (313) 821-3900 | |
| (313) 821-1511 |
| Full Name | Park Medical Centers |
|---|---|
| Speciality | Family Medicine |
| Location | 12871 E Jefferson Ave, Detroit, Michigan |
| Authorized Official Name and Position | Jeffrey Howard Brown (CEO) |
| Authorized Official Contact | 2483565555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Medical Centers 28212 Franklin Rd Southfield MI 48034-1659 Ph: (248) 356-5555 | Park Medical Centers 12871 E Jefferson Ave Detroit MI 48215-2754 Ph: (313) 821-3900 |
| NPI Number | 1437161437 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 05/18/2020 |
| Medicare PECOS PAC ID | 9638077621 |
|---|---|
| Medicare Enrollment ID | O20031231000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437161437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jaroslaw Sawka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750373478 PECOS PAC ID: 8820997844 Enrollment ID: I20040108000089 |
| Provider Name | Robert C Levine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104815232 PECOS PAC ID: 3476456112 Enrollment ID: I20040129000807 |
| Provider Name | Anthony A Bennett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801866397 PECOS PAC ID: 0749176394 Enrollment ID: I20040223000471 |
| Provider Name | Anton Bahu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366412272 PECOS PAC ID: 5991792251 Enrollment ID: I20040428000895 |
| Provider Name | Edith Nemeth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841391133 PECOS PAC ID: 1759350986 Enrollment ID: I20040924000961 |
| Provider Name | Frank D Winters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093785941 PECOS PAC ID: 7315934668 Enrollment ID: I20040930000308 |
| Provider Name | Troy M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922078450 PECOS PAC ID: 9739176090 Enrollment ID: I20040930000356 |
| Provider Name | Rita Rani Khaneja Sharrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982691846 PECOS PAC ID: 4385609155 Enrollment ID: I20041122000655 |
| Provider Name | Dennis M Mcmahon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902892706 PECOS PAC ID: 0547226177 Enrollment ID: I20041206000933 |
| Provider Name | William F Rollins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629048152 PECOS PAC ID: 7810984176 Enrollment ID: I20050303000860 |
| Provider Name | Daniel R Harber |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861472714 PECOS PAC ID: 1759337454 Enrollment ID: I20050325000123 |
| Provider Name | Richard Anthony Ozog |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144278367 PECOS PAC ID: 2668483199 Enrollment ID: I20060518000115 |
| Provider Name | Robert K Brummeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831205806 PECOS PAC ID: 3971602814 Enrollment ID: I20070619000221 |
| Provider Name | Eduardo C Abellana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215929906 PECOS PAC ID: 5395827554 Enrollment ID: I20080125000682 |
| Provider Name | Debra M Van Ort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770634305 PECOS PAC ID: 1355412172 Enrollment ID: I20080620000427 |
| Provider Name | Elliott I Greenspan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003803966 PECOS PAC ID: 3577459064 Enrollment ID: I20091124000348 |
| Provider Name | Richard M Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801888565 PECOS PAC ID: 4385542380 Enrollment ID: I20100115000718 |
| Provider Name | Emilio Cardona Ortiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265424816 PECOS PAC ID: 9436288412 Enrollment ID: I20100601000494 |
| Provider Name | Gloria E Chaney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548252240 PECOS PAC ID: 6709916414 Enrollment ID: I20100607000477 |
| Provider Name | Barry D Bronstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699767475 PECOS PAC ID: 8123159704 Enrollment ID: I20100625000334 |
| Provider Name | Katherine M Metcalf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669439758 PECOS PAC ID: 2668485129 Enrollment ID: I20130328000494 |
| Provider Name | Almeta M Andary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477987188 PECOS PAC ID: 6204066343 Enrollment ID: I20140311000980 |
| Provider Name | Vera B Jaber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871917724 PECOS PAC ID: 0446473714 Enrollment ID: I20140514001994 |
| Provider Name | Yolanda Yvette Latham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427418656 PECOS PAC ID: 0244523181 Enrollment ID: I20160729000571 |
| Provider Name | Diane M Yirenkyi George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952758476 PECOS PAC ID: 7315236940 Enrollment ID: I20170130001945 |
| Provider Name | Nikole S Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194278622 PECOS PAC ID: 3678858263 Enrollment ID: I20170322001276 |
| Provider Name | Thera T Radney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396281234 PECOS PAC ID: 7012284045 Enrollment ID: I20170523002439 |
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Chass Mack Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3426 Mack Avenue, Detroit, MI 48207 Phone: 313-849-3920 | |
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