Tricounty Hospitalists, Pllc | |
11800 E 12 Mile Rd Warren MI 48093-3472 | |
(586) 573-5000 | |
(248) 265-4082 |
Full Name | Tricounty Hospitalists, Pllc |
---|---|
Speciality | Hospitalist |
Location | 11800 E 12 Mile Rd, Warren, Michigan |
Authorized Official Name and Position | Raghu Mulpuri (OWNER) |
Authorized Official Contact | 3135954758 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tricounty Hospitalists, Pllc 625 Perrien Pl Grosse Pointe Woods MI 48236-1132 Ph: (313) 595-4758 | Tricounty Hospitalists, Pllc 11800 E 12 Mile Rd Warren MI 48093-3472 Ph: (586) 573-5000 |
NPI Number | 1003831173 |
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Provider Enumeration Date | 07/12/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003831173 | NPI | - | NPPES |
4841598 | Medicaid | MI | |
1108205692 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301061786 (Michigan) | Primary |
208M00000X | Hospitalist | 4301061786 (Michigan) | Primary |
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