| Suresha Bandara Mdpc | |
|
3147 Chestnut Run Dr Bloomfield Hills MI 48302-1112 | |
| (248) 892-0316 | |
| Not Available |
| Full Name | Suresha Bandara Mdpc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3147 Chestnut Run Dr, Bloomfield Hills, Michigan |
| Authorized Official Name and Position | Suresha Chandani Bandara (PROVIDER) |
| Authorized Official Contact | 2488920316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suresha Bandara Mdpc 3147 Chestnut Run Dr Bloomfield MI 48302-1112 Ph: (248) 892-0316 | Suresha Bandara Mdpc 3147 Chestnut Run Dr Bloomfield Hills MI 48302-1112 Ph: (248) 892-0316 |
| NPI Number | 1588445787 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 01/10/2024 |
| Medicare PECOS PAC ID | 4284801218 |
|---|---|
| Medicare Enrollment ID | O20120116000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588445787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Suresha C Bandara |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841457454 PECOS PAC ID: 3476749680 Enrollment ID: I20101130001273 |
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