| Southeast Michigan Medical Associates Pc | |
|
18451 W 12 Mile Rd Ste 200 Lathrup Village MI 48076-2644 | |
| (248) 827-7612 | |
| (248) 827-7615 |
| Full Name | Southeast Michigan Medical Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18451 W 12 Mile Rd, Lathrup Village, Michigan |
| Authorized Official Name and Position | Ashok Kumar Bansal (PRESIDENT) |
| Authorized Official Contact | 2488277612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Michigan Medical Associates Pc 18451 W 12 Mile Rd Ste 200 Lathrup Village MI 48076-2644 Ph: (248) 827-7612 | Southeast Michigan Medical Associates Pc 18451 W 12 Mile Rd Ste 200 Lathrup Village MI 48076-2644 Ph: (248) 827-7612 |
| NPI Number | 1417001660 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 02/21/2017 |
| Medicare PECOS PAC ID | 0244128981 |
|---|---|
| Medicare Enrollment ID | O20040305000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417001660 | NPI | - | NPPES |
| 1106306332 | Other | MI | BCBSM |
| 3150549 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301057441 (Michigan) | Primary |
| Provider Name | Vishnuvardhan G Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376522763 PECOS PAC ID: 6800794124 Enrollment ID: I20031223000736 |
| Provider Name | Ashok K Bansal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114908209 PECOS PAC ID: 8527956283 Enrollment ID: I20040308000091 |
| Provider Name | Allan M Schwartz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487653572 PECOS PAC ID: 7012086549 Enrollment ID: I20080523000027 |
| Provider Name | Zaid S Yaldo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447514237 PECOS PAC ID: 0840512968 Enrollment ID: I20141201000312 |
| Provider Name | Nicole A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063076610 PECOS PAC ID: 5193051977 Enrollment ID: I20190731004029 |
Raveend Thabolingam Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18161 W 12 Mile Rd, Suite 2, Lathrup Village, MI 48076 Phone: 248-552-1200 Fax: 248-552-1201 | |
Muksi, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 26411 Southfield Rd, Lathrup Village, MI 48076 Phone: 248-552-8195 Fax: 248-552-8537 | |
Riyadh P. Kasmikha, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28500 Southfield Rd, Suite 200, Lathrup Village, MI 48076 Phone: 248-440-2185 Fax: 248-440-2189 | |
Dr Anderson And Associates P. C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26237 Southfield Rd, Lathrup Village, MI 48076 Phone: 248-395-6201 | |
Maximum Rehabilitation & Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18211 W 12 Mile Rd Ste 2w, Lathrup Village, MI 48076 Phone: 248-629-0904 Fax: 248-629-4010 | |
Harris House Calls M.d., Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18849 Middlesex Ave, Lathrup Village, MI 48076 Phone: 248-310-1175 |