Primary Healthcare Michigan Plc | |
5092 W Vienna Rd Ste G Clio MI 48420-2804 | |
(810) 686-2212 | |
Not Available |
Full Name | Primary Healthcare Michigan Plc |
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Speciality | Family Medicine |
Location | 5092 W Vienna Rd Ste G, Clio, Michigan |
Authorized Official Name and Position | Pauline Aquino (OWNER) |
Authorized Official Contact | 8106862212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Healthcare Michigan Plc 5092 W Vienna Rd Ste G Clio MI 48420-2804 Ph: () - | Primary Healthcare Michigan Plc 5092 W Vienna Rd Ste G Clio MI 48420-2804 Ph: (810) 686-2212 |
NPI Number | 1023521192 |
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Provider Enumeration Date | 11/13/2017 |
Last Update Date | 11/13/2017 |
Medicare PECOS PAC ID | 2163782137 |
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Medicare Enrollment ID | O20180213000334 |
Identifier | Type | State | Issuer |
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1023521192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Pauline C Aquino |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356370407 PECOS PAC ID: 5193790111 Enrollment ID: I20040901000598 |
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