| Port Huron Internal Medicine Associates | |
|
2540 16th St Port Huron MI 48060-6405 | |
| (810) 987-1000 | |
| (810) 982-1810 |
| Full Name | Port Huron Internal Medicine Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 2540 16th St, Port Huron, Michigan |
| Authorized Official Name and Position | John I Jarad (PRESIDENT) |
| Authorized Official Contact | 8109871000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Huron Internal Medicine Associates 2540 16th St Port Huron MI 48060-6405 Ph: (810) 987-1000 | Port Huron Internal Medicine Associates 2540 16th St Port Huron MI 48060-6405 Ph: (810) 987-1000 |
| NPI Number | 1528252251 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 02/06/2015 |
| Medicare PECOS PAC ID | 2567497910 |
|---|---|
| Medicare Enrollment ID | O20051004000919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528252251 | NPI | - | NPPES |
| 0G41221 | Other | MI | BCBSM |
| 34108 | Other | MI | HEALTH PLAN OF MICHIGAN |
| DG3605 | Other | MI | RAILROAD MEDICARE PIN |
| Provider Name | Cheryl A Canto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164423216 PECOS PAC ID: 2062316896 Enrollment ID: I20031124000298 |
| Provider Name | John I Jarad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245235654 PECOS PAC ID: 1456386804 Enrollment ID: I20051024000657 |
| Provider Name | Wayel T Katrib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366671174 PECOS PAC ID: 1557527652 Enrollment ID: I20120717000624 |
| Provider Name | Stephanie Maniaci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114302130 PECOS PAC ID: 4183992407 Enrollment ID: I20170609000903 |
| Provider Name | Travis Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821711839 PECOS PAC ID: 9436511664 Enrollment ID: I20230818002499 |
| Provider Name | Regan Elizabeth Havens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164146650 PECOS PAC ID: 8921454489 Enrollment ID: I20231019003570 |
| Provider Name | Lisa Marie Hash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174397186 PECOS PAC ID: 4789020249 Enrollment ID: I20240307000930 |
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