| Wadhams Family Care Pllc | |
|
5312 Lapeer Rd Kimball MI 48074-1424 | |
| (810) 984-2693 | |
| (810) 984-2669 |
| Full Name | Wadhams Family Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5312 Lapeer Rd, Kimball, Michigan |
| Authorized Official Name and Position | Kay L Robbins (PRACTICE MANAGER) |
| Authorized Official Contact | 8109842693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wadhams Family Care Pllc 5312 Lapeer Rd Kimball MI 48074-1424 Ph: (810) 984-2693 | Wadhams Family Care Pllc 5312 Lapeer Rd Kimball MI 48074-1424 Ph: (810) 984-2693 |
| NPI Number | 1073764932 |
|---|---|
| Provider Enumeration Date | 10/08/2008 |
| Last Update Date | 01/11/2010 |
| Medicare PECOS PAC ID | 4284797689 |
|---|---|
| Medicare Enrollment ID | O20090112000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073764932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | GJ012784 (Michigan) | Primary |
| 261QP2300X | Clinic/center - Primary Care | PS012787 (Michigan) | Secondary |
| Provider Name | Gary A James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255317178 PECOS PAC ID: 3971552647 Enrollment ID: I20050120000105 |
| Provider Name | Paul T Somerville |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598738304 PECOS PAC ID: 9931158615 Enrollment ID: I20050120000150 |
| Provider Name | Gina F Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962051482 PECOS PAC ID: 3678906740 Enrollment ID: I20191203001879 |