| S E Michigan Family Practice Pc | |
|
350 E 12 Mile Rd Madison Heights MI 48071-2531 | |
| (248) 399-3550 | |
| (248) 399-6136 |
| Full Name | S E Michigan Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 350 E 12 Mile Rd, Madison Heights, Michigan |
| Authorized Official Name and Position | Erwin E Feldman (PRESIDENT) |
| Authorized Official Contact | 2483993550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S E Michigan Family Practice Pc 350 E 12 Mile Rd Madison Heights MI 48071-2531 Ph: (248) 399-3550 | S E Michigan Family Practice Pc 350 E 12 Mile Rd Madison Heights MI 48071-2531 Ph: (248) 399-3550 |
| NPI Number | 1699883819 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 02/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699883819 | NPI | - | NPPES |
| 0156312614 | Other | MI | BC |
| 470701711 | Medicaid | MI | |
| EF055658 | Other | MI | LICENSE # |
| E25802 | Other | MI | HAP |
| 0F33895 | Other | MI | BCBSM |
| 124302 | Other | MI | CARE CHOICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | EF055658 (Michigan) | Primary |
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