| Platinum Care Physicians Pc | |
|
27207 Lahser Rd Suite 250 Southfield MI 48034-2168 | |
| (248) 967-3200 | |
| (248) 967-1387 |
| Full Name | Platinum Care Physicians Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 27207 Lahser Rd, Southfield, Michigan |
| Authorized Official Name and Position | Aquarius Bouier (MANAGER) |
| Authorized Official Contact | 2489673200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Platinum Care Physicians Pc 27207 Lahser Rd Suite 250 Southfield MI 48034-2168 Ph: (248) 967-3200 | Platinum Care Physicians Pc 27207 Lahser Rd Suite 250 Southfield MI 48034-2168 Ph: (248) 967-3200 |
| NPI Number | 1245633411 |
|---|---|
| Provider Enumeration Date | 10/02/2014 |
| Last Update Date | 06/23/2015 |
| Medicare PECOS PAC ID | 6406179373 |
|---|---|
| Medicare Enrollment ID | O20141229001650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245633411 | NPI | - | NPPES |
| 0H71585 | Other | MI | BCBSM PIN/FACILITY CODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 5101007369 (Michigan) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 5101012320 (Michigan) | Secondary |
| Provider Name | Arthur I Bouier |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1649292269 PECOS PAC ID: 6901871102 Enrollment ID: I20040901000198 |
| Provider Name | Michelle B Calhoun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972678548 PECOS PAC ID: 5395837512 Enrollment ID: I20070817000288 |
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