| Southgate Medical Clinic Pc | |
|
13819 Trenton Rd Southgate MI 48195-1830 | |
| (734) 282-7911 | |
| Not Available |
| Full Name | Southgate Medical Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13819 Trenton Rd, Southgate, Michigan |
| Authorized Official Name and Position | Syed M Danish (PRESIDENT) |
| Authorized Official Contact | 7342827911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southgate Medical Clinic Pc 13819 Trenton Rd Southgate MI 48195-1830 Ph: (734) 282-7911 | Southgate Medical Clinic Pc 13819 Trenton Rd Southgate MI 48195-1830 Ph: (734) 282-7911 |
| NPI Number | 1588702690 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 07/01/2010 |
| Medicare PECOS PAC ID | 2961682356 |
|---|---|
| Medicare Enrollment ID | O20110201000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588702690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Syed M Danish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326057589 PECOS PAC ID: 3779763164 Enrollment ID: I20110201000849 |
| Provider Name | Roselyne A Ogola-mwangale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821477258 PECOS PAC ID: 7214242940 Enrollment ID: I20150810002990 |
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