| Plymouth Canton Family Health Care Pc | |
|
44633 Joy Rd Ste 100 Canton MI 48187-1731 | |
| (734) 453-5360 | |
| (734) 453-5380 |
| Full Name | Plymouth Canton Family Health Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 44633 Joy Rd Ste 100, Canton, Michigan |
| Authorized Official Name and Position | Jerome Bekker (PHYSICIAN) |
| Authorized Official Contact | 7344535360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plymouth Canton Family Health Care Pc Po Box 700890 Plymouth MI 48170-0955 Ph: (734) 453-5360 | Plymouth Canton Family Health Care Pc 44633 Joy Rd Ste 100 Canton MI 48187-1731 Ph: (734) 453-5360 |
| NPI Number | 1518095850 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 02/17/2011 |
| Medicare PECOS PAC ID | 6204875644 |
|---|---|
| Medicare Enrollment ID | O20050426000862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518095850 | NPI | - | NPPES |
| 114731255 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | JB010278 (Michigan) | Primary |
| Provider Name | Jerome E Bekker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336105014 PECOS PAC ID: 1456390897 Enrollment ID: I20050502000351 |
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