| Vincent R.c. Maribao Md Pc | |
|
29167 Jefferson Ave Ste 100 Saint Clair Shores MI 48081-1331 | |
| (586) 498-1160 | |
| Not Available |
| Full Name | Vincent R.c. Maribao Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 29167 Jefferson Ave Ste 100, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Vincent R. C. Maribao (OWNER) |
| Authorized Official Contact | 5864981160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent R.c. Maribao Md Pc 29167 Jefferson Ave Ste 100 Saint Clair Shores MI 48081-1331 Ph: (586) 498-1160 | Vincent R.c. Maribao Md Pc 29167 Jefferson Ave Ste 100 Saint Clair Shores MI 48081-1331 Ph: (586) 498-1160 |
| NPI Number | 1730114760 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 5597760298 |
|---|---|
| Medicare Enrollment ID | O20061003000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730114760 | NPI | - | NPPES |
| 4177064 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Vincent Maribao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902835168 PECOS PAC ID: 3678578374 Enrollment ID: I20061012000117 |
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