| Tac Medical Center Pc | |
|
1120 E Long Lake Rd Ste 120 Troy MI 48085-4998 | |
| (248) 946-9400 | |
| (586) 816-1904 |
| Full Name | Tac Medical Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1120 E Long Lake Rd Ste 120, Troy, Michigan |
| Authorized Official Name and Position | Tarek A Chahine (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2486703617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tac Medical Center Pc 1120 E Long Lake Rd Ste 120 Troy MI 48085-4998 Ph: (248) 946-9400 | Tac Medical Center Pc 1120 E Long Lake Rd Ste 120 Troy MI 48085-4998 Ph: (248) 946-9400 |
| NPI Number | 1518695303 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 09/12/2022 |
| Medicare PECOS PAC ID | 7517341399 |
|---|---|
| Medicare Enrollment ID | O20220827000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518695303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Tarek Ali Chahine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699272237 PECOS PAC ID: 8426440215 Enrollment ID: I20220128001555 |
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