| Woodward Corridor Family Medical Center | |
|
611 Martin Luther King Jr Blvd Detroit MI 48201-2273 | |
| (313) 832-6300 | |
| (313) 832-8341 |
| Full Name | Woodward Corridor Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 Martin Luther King Jr Blvd, Detroit, Michigan |
| Authorized Official Name and Position | Mahipal Rao Kakarala (SRVP/CFO) |
| Authorized Official Contact | 3138212591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodward Corridor Family Medical Center 13901 E Jefferson Ave Detroit MI 48215-2720 Ph: (313) 821-2591 | Woodward Corridor Family Medical Center 611 Martin Luther King Jr Blvd Detroit MI 48201-2273 Ph: (313) 832-6300 |
| NPI Number | 1790948982 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 04/27/2013 |
| Medicare PECOS PAC ID | 9234021148 |
|---|---|
| Medicare Enrollment ID | O20080718000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790948982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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