| Prime Care Physician Pc | |
|
121 W 13 Mile Rd Madison Heights MI 48071-1857 | |
| (248) 583-0960 | |
| (248) 583-0961 |
| Full Name | Prime Care Physician Pc |
|---|---|
| Speciality | General Practice |
| Location | 121 W 13 Mile Rd, Madison Heights, Michigan |
| Authorized Official Name and Position | Girija Maripudi (OWNER) |
| Authorized Official Contact | 2485830960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Care Physician Pc 121 W 13 Mile Rd Madison Heights MI 48071-1857 Ph: (248) 583-0960 | Prime Care Physician Pc 121 W 13 Mile Rd Madison Heights MI 48071-1857 Ph: (248) 583-0960 |
| NPI Number | 1568635282 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 02/25/2013 |
| Medicare PECOS PAC ID | 2567454507 |
|---|---|
| Medicare Enrollment ID | O20040331000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568635282 | NPI | - | NPPES |
| 4593972 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301066341 (Michigan) | Primary |
| Provider Name | Girija Maripudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346306685 PECOS PAC ID: 8628965811 Enrollment ID: I20040302001065 |
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