Prasad Mikkilineni Md Pllc | |
36975 Five Mile Rd Livonia MI 48154-1871 | |
(734) 464-0600 | |
Not Available |
Full Name | Prasad Mikkilineni Md Pllc |
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Speciality | Internal Medicine |
Location | 36975 Five Mile Rd, Livonia, Michigan |
Authorized Official Name and Position | Irene Martin (BILLER) |
Authorized Official Contact | 7346742739 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prasad Mikkilineni Md Pllc 18576 Shadyside St Livonia MI 48152-3246 Ph: (734) 674-2739 | Prasad Mikkilineni Md Pllc 36975 Five Mile Rd Livonia MI 48154-1871 Ph: (734) 464-0600 |
NPI Number | 1629582226 |
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Provider Enumeration Date | 11/20/2017 |
Last Update Date | 11/20/2017 |
Medicare PECOS PAC ID | 6002175163 |
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Medicare Enrollment ID | O20180117001847 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629582226 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301039936 (Michigan) | Primary |
Provider Name | Prasad L Mikkilineni |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1871585562 PECOS PAC ID: 2961502364 Enrollment ID: I20100204000787 |
Provider Name | Sarah Belinov |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306370879 PECOS PAC ID: 2264790419 Enrollment ID: I20171218002605 |
Provider Name | Angela Laverne Watkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295371649 PECOS PAC ID: 9335576230 Enrollment ID: I20200304002338 |
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