| Primary Care Physician Network P C | |
|
4136 Legacy Pkwy Suite 110 Lansing MI 48911-4265 | |
| (517) 206-1388 | |
| Not Available |
| Full Name | Primary Care Physician Network P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 4136 Legacy Pkwy, Lansing, Michigan |
| Authorized Official Name and Position | Asher Javaid Bashir (CEO) |
| Authorized Official Contact | 5172061388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Physician Network P C 2843 E Grand River Ave Box 260 East Lansing MI 48823-6722 Ph: (517) 206-1388 | Primary Care Physician Network P C 4136 Legacy Pkwy Suite 110 Lansing MI 48911-4265 Ph: (517) 206-1388 |
| NPI Number | 1104253111 |
|---|---|
| Provider Enumeration Date | 10/04/2013 |
| Last Update Date | 10/04/2013 |
| Medicare PECOS PAC ID | 0840428801 |
|---|---|
| Medicare Enrollment ID | O20140121000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104253111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Zahirul Talukder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861678856 PECOS PAC ID: 5294850590 Enrollment ID: I20100909001029 |
| Provider Name | Stephanie L Shafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386958874 PECOS PAC ID: 4082803879 Enrollment ID: I20110110000509 |
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