| St. Michael's Internal Medicine Physicians, Pllc | |
|
4448 Forestview Dr West Bloomfield MI 48322-4507 | |
| (248) 217-8405 | |
| Not Available |
| Full Name | St. Michael's Internal Medicine Physicians, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4448 Forestview Dr, West Bloomfield, Michigan |
| Authorized Official Name and Position | Revark Kammo (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2482178405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Michael's Internal Medicine Physicians, Pllc 4448 Forestview Dr West Bloomfield MI 48322-4507 Ph: () - | St. Michael's Internal Medicine Physicians, Pllc 4448 Forestview Dr West Bloomfield MI 48322-4507 Ph: (248) 217-8405 |
| NPI Number | 1205318722 |
|---|---|
| Provider Enumeration Date | 08/30/2018 |
| Last Update Date | 08/30/2018 |
| Medicare PECOS PAC ID | 8022358563 |
|---|---|
| Medicare Enrollment ID | O20190320002520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205318722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sameer Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972725083 PECOS PAC ID: 6406921311 Enrollment ID: I20120709000504 |
| Provider Name | Anmar E Sheet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831415116 PECOS PAC ID: 8224282587 Enrollment ID: I20130214000229 |
| Provider Name | Revark D Kammo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326335241 PECOS PAC ID: 1456577428 Enrollment ID: I20140728001952 |
| Provider Name | Adrian Michel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851955777 PECOS PAC ID: 2668715004 Enrollment ID: I20220817003689 |
| Provider Name | Rita Kassab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497384622 PECOS PAC ID: 2466871447 Enrollment ID: I20230522003391 |
| Provider Name | Jolene Kassab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508442880 PECOS PAC ID: 5496112310 Enrollment ID: I20230608002123 |
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