| Pioneer Medical Group Pllc | |
|
6071 W Outer Dr Detroit MI 48235-2624 | |
| (248) 912-8080 | |
| (734) 462-0340 |
| Full Name | Pioneer Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6071 W Outer Dr, Detroit, Michigan |
| Authorized Official Name and Position | Rizwan Khan (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2489128080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pioneer Medical Group Pllc 17177 N Laurel Park Dr Ste 439 Livonia MI 48152-3938 Ph: (734) 462-0340 | Pioneer Medical Group Pllc 6071 W Outer Dr Detroit MI 48235-2624 Ph: (248) 912-8080 |
| NPI Number | 1801304688 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 05/28/2020 |
| Medicare PECOS PAC ID | 5092075598 |
|---|---|
| Medicare Enrollment ID | O20180131003349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801304688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Talisha Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215197082 PECOS PAC ID: 4688852650 Enrollment ID: I20110621000567 |
| Provider Name | Rizwan Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376876102 PECOS PAC ID: 8527201607 Enrollment ID: I20130821000957 |
| Provider Name | Carmelite Dalmacy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447660659 PECOS PAC ID: 9830312396 Enrollment ID: I20140602001210 |
| Provider Name | Ali Lutfi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851633663 PECOS PAC ID: 2466746201 Enrollment ID: I20160810000276 |
| Provider Name | Muddasser Saiyed-javed |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417105420 PECOS PAC ID: 2769641232 Enrollment ID: I20160822002481 |
| Provider Name | Shantae Monae Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417406752 PECOS PAC ID: 3870878010 Enrollment ID: I20170330000760 |
| Provider Name | Humaira Rizvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225447766 PECOS PAC ID: 8426342031 Enrollment ID: I20170615002682 |
| Provider Name | Irena Muca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740661982 PECOS PAC ID: 9537432984 Enrollment ID: I20170906001949 |
| Provider Name | Tonya Lee Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376050096 PECOS PAC ID: 7618231689 Enrollment ID: I20180430001042 |
| Provider Name | Chi Zhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235596941 PECOS PAC ID: 6002164035 Enrollment ID: I20180807002393 |
| Provider Name | Amarachi Charity Duru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588163992 PECOS PAC ID: 1658623400 Enrollment ID: I20181006000261 |
| Provider Name | Avazeh Amirsadri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780174631 PECOS PAC ID: 2365796927 Enrollment ID: I20181116002093 |
| Provider Name | Fares N Mubarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831753466 PECOS PAC ID: 4688917305 Enrollment ID: I20190521002932 |
| Provider Name | Sara Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023670015 PECOS PAC ID: 9133458193 Enrollment ID: I20190917001584 |
| Provider Name | Ashraf Hamza Ahmed Abugroun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619324936 PECOS PAC ID: 3577858471 Enrollment ID: I20191119003019 |
| Provider Name | Brett Alan Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801434873 PECOS PAC ID: 6800221953 Enrollment ID: I20200117000185 |
| Provider Name | Kaodichinma Ogbonna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972076693 PECOS PAC ID: 4587099635 Enrollment ID: I20200117000399 |
| Provider Name | Fatima Younus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962922013 PECOS PAC ID: 3072936020 Enrollment ID: I20200708003772 |
| Provider Name | Ashley Marie Sentell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891396800 PECOS PAC ID: 3476965716 Enrollment ID: I20201210001873 |
| Provider Name | Mohammad Ekram Rahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558868711 PECOS PAC ID: 3375943616 Enrollment ID: I20210608003438 |
| Provider Name | Oluwasayo T Akinyosoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588191761 PECOS PAC ID: 1557610524 Enrollment ID: I20210625002278 |
| Provider Name | Mohammad Khalil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265028542 PECOS PAC ID: 9436551546 Enrollment ID: I20210713000610 |
| Provider Name | Samaa Lutfi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760988406 PECOS PAC ID: 1557610888 Enrollment ID: I20210729002210 |
| Provider Name | Lindsey D O'neil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871027045 PECOS PAC ID: 6709154529 Enrollment ID: I20210730001698 |
| Provider Name | Jamie L Rates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992326946 PECOS PAC ID: 9537565593 Enrollment ID: I20210831002108 |
| Provider Name | Kimberlee Denise Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982285938 PECOS PAC ID: 6406246768 Enrollment ID: I20211201001754 |
| Provider Name | Ali Hajj Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639673759 PECOS PAC ID: 7618232513 Enrollment ID: I20220420001863 |
| Provider Name | Yunsun Lentz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932781762 PECOS PAC ID: 7416335252 Enrollment ID: I20220607000456 |
| Provider Name | Ameen A Masoodi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508429960 PECOS PAC ID: 5496089369 Enrollment ID: I20230329000585 |
| Provider Name | Xiaogang Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740056159 PECOS PAC ID: 6901257054 Enrollment ID: I20240112002463 |
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