| Wayne Medical Center Pllc | |
|
1203 S Wayne Rd Westland MI 48186-4362 | |
| (734) 729-5780 | |
| (734) 729-7730 |
| Full Name | Wayne Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1203 S Wayne Rd, Westland, Michigan |
| Authorized Official Name and Position | Modini Chinta Liyanage (PRESIDENT) |
| Authorized Official Contact | 7347295780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Medical Center Pllc 1203 S Wayne Rd Westland MI 48186-4362 Ph: (734) 729-5780 | Wayne Medical Center Pllc 1203 S Wayne Rd Westland MI 48186-4362 Ph: (734) 729-5780 |
| NPI Number | 1396960308 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 02/18/2011 |
| Medicare PECOS PAC ID | 8729067640 |
|---|---|
| Medicare Enrollment ID | O20040715000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396960308 | NPI | - | NPPES |
| 611793200 | Other | MI | USPOSTAL WORKMEN COMP |
| 139077 | Other | MI | CARE CHOICES |
| K583 | Other | MI | MCARE GROUP NUMBER |
| 023685 | Other | MI | MIDWEST HEALTH PLAN |
| 700H221880 | Other | MI | BCBSM GROUP NUMBER |
| 700H221880 | Other | MI | BCN GROUP NUMBER |
| 16625 | Other | MI | MCARE INDIVIDUAL NUMBER |
| 7589557 | Other | MI | AETNA |
| H98425 | Other | MI | HAP NUMBER |
| P00213848 | Other | MI | RAILROAD MEDICARE |
| 139077 | Other | MI | PREFERRED CHOICES |
| 4626563 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301074724 (Michigan) | Primary |
| Provider Name | Modini Chintha Liyanage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457450413 PECOS PAC ID: 3779476205 Enrollment ID: I20040206000570 |
| Provider Name | Monzer M Saad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609009778 PECOS PAC ID: 6406000215 Enrollment ID: I20130202000030 |
| Provider Name | Rupinder K Dadiala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730761594 PECOS PAC ID: 8325449788 Enrollment ID: I20210623002559 |
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