| Alexia Elisabeth Minanov, MD | |
|
30061 Schoenherr Rd, Suite A, Warren, MI 48088-3133 | |
| (586) 558-2111 | |
| (586) 558-2169 |
| Full Name | Alexia Elisabeth Minanov |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 30061 Schoenherr Rd, Warren, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255442224 | NPI | - | NPPES |
| 4688593 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | AM081003 (Michigan) | Primary |
| Entity Name | Beaumont Medical Group Hospital Based Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427567858 PECOS PAC ID: 3072875889 Enrollment ID: O20180314001796 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexia Elisabeth Minanov, MD 30061 Schoenherr Rd, Suite A, Warren, MI 48088-3133 Ph: (586) 558-2111 | Alexia Elisabeth Minanov, MD 30061 Schoenherr Rd, Suite A, Warren, MI 48088-3133 Ph: (586) 558-2111 |
Eileen Hug, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30205 Schoenherr Rd, Warren, MI 48088 Phone: 586-759-7510 Fax: 586-759-7791 |
Banumathy Subramanian, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 29703 Hoover Rd, Steb, Warren, MI 48093 Phone: 586-573-9090 Fax: 586-573-2128 |
Ganga D Nadarajah, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30061 Schoenherr Rd, Suite A, Warren, MI 48088 Phone: 586-558-2111 Fax: 586-558-2169 |
Suzanne Woltanski, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13355 E 10 Mile Rd, Warren, MI 48089 Phone: 586-759-7510 Fax: 586-759-7791 |
Dr. Ashraf H Berry, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 27070 Hoover Rd, Warren, MI 48093 Phone: 586-573-9090 Fax: 586-573-2128 |
Michelle Desmet Foster, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30061 Schoenherr, Suite A, Warren, MI 48088 Phone: 586-558-2111 Fax: 586-558-2169 |
Jeannette Marchand-mateyak, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30061 Schoenherr Rd, Suite A, Warren, MI 48088 Phone: 586-558-2111 Fax: 586-558-2169 |