| Pfefferkorn Md Pllc | |
|
46325 W 12 Mile Rd Ste 390 Novi MI 48377-2464 | |
| (248) 719-7271 | |
| Not Available |
| Full Name | Pfefferkorn Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 46325 W 12 Mile Rd Ste 390, Novi, Michigan |
| Authorized Official Name and Position | Tassia Zoma Pfefferkorn (OWNER) |
| Authorized Official Contact | 2488608009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pfefferkorn Md Pllc 6490 Brockhurst Blvd W Bloomfield MI 48322-1230 Ph: () - | Pfefferkorn Md Pllc 46325 W 12 Mile Rd Ste 390 Novi MI 48377-2464 Ph: (248) 719-7271 |
| NPI Number | 1891303061 |
|---|---|
| Provider Enumeration Date | 07/14/2020 |
| Last Update Date | 06/29/2022 |
| Medicare PECOS PAC ID | 3779900493 |
|---|---|
| Medicare Enrollment ID | O20200826002812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891303061 | NPI | - | NPPES |
| 4301100187 | Other | MI | LARA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tassia Pfefferkorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467716514 PECOS PAC ID: 9638486749 Enrollment ID: I20150922000305 |
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