| Warren Gastroenterology Pc | |
|
27560 Hoover Rd Warren MI 48093-4505 | |
| (586) 757-6400 | |
| (586) 757-8400 |
| Full Name | Warren Gastroenterology Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 27560 Hoover Rd, Warren, Michigan |
| Authorized Official Name and Position | Ghaith M Ibrahim (PRESIDENT) |
| Authorized Official Contact | 5867576400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Gastroenterology Pc Po Box 1920 Troy MI 48099-1920 Ph: (586) 757-6400 | Warren Gastroenterology Pc 27560 Hoover Rd Warren MI 48093-4505 Ph: (586) 757-6400 |
| NPI Number | 1023211422 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 03/16/2010 |
| Medicare PECOS PAC ID | 9133214182 |
|---|---|
| Medicare Enrollment ID | O20071005000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023211422 | NPI | - | NPPES |
| 4813806 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Michigan) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (Michigan) | Primary |
| Provider Name | Rabei W Bdeir |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619920634 PECOS PAC ID: 8527031368 Enrollment ID: I20040818001164 |
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