Physician Primary Care Pllc | |
6255 Inkster Rd Ste 101 Garden City MI 48135-2538 | |
(248) 275-1144 | |
(248) 275-1146 |
Full Name | Physician Primary Care Pllc |
---|---|
Speciality | Family Medicine |
Location | 6255 Inkster Rd Ste 101, Garden City, Michigan |
Authorized Official Name and Position | Chandramani Mohan (OWNER) |
Authorized Official Contact | 2482751144 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Physician Primary Care Pllc 6255 Inkster Rd Ste 101 Garden City MI 48135-2538 Ph: (248) 275-1144 | Physician Primary Care Pllc 6255 Inkster Rd Ste 101 Garden City MI 48135-2538 Ph: (248) 275-1144 |
NPI Number | 1740035955 |
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Provider Enumeration Date | 04/22/2024 |
Last Update Date | 04/22/2024 |
Medicare PECOS PAC ID | 3375983695 |
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Medicare Enrollment ID | O20240502002913 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740035955 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Chandramani Mohan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821215435 PECOS PAC ID: 1254649528 Enrollment ID: I20180518002422 |
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