| Samyuktha Rani Madishetty Md Pc | |
|
24100 Oxford St Dearborn MI 48124 | |
| (313) 561-3000 | |
| (313) 561-4831 |
| Full Name | Samyuktha Rani Madishetty Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 24100 Oxford St, Dearborn, Michigan |
| Authorized Official Name and Position | Samyuktha Rani Madishetty (OWNER) |
| Authorized Official Contact | 3135613000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samyuktha Rani Madishetty Md Pc 24100 Oxford St Dearborn MI 48124-2481 Ph: (313) 561-3000 | Samyuktha Rani Madishetty Md Pc 24100 Oxford St Dearborn MI 48124 Ph: (313) 561-3000 |
| NPI Number | 1487867644 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 3274630322 |
|---|---|
| Medicare Enrollment ID | O20070524000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487867644 | NPI | - | NPPES |
| 110H237950 | Other | MI | BCBS GROUP |
| 110H237950 | Other | MI | BCN GROUP |
| DH0704 | Other | MI | RAILROAD MEDICARE GROUP |
| 1487867644 | Medicaid | MI | |
| I46399 | Other | MI | HAP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301080548 (Michigan) | Primary |
| Provider Name | Samyuktha R Madishetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770650889 PECOS PAC ID: 2668492554 Enrollment ID: I20051207000354 |
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