| Brent Fuller, | |
|
3535 W 13 Mile Rd Ste Ll, Royal Oak, MI 48073-6770 | |
| (248) 551-3000 | |
| Not Available |
| Full Name | Brent Fuller |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 28 Years |
| Location | 3535 W 13 Mile Rd Ste Ll, Royal Oak, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871552646 | NPI | - | NPPES |
| 4800002 | Medicaid | MI | |
| 110F376980 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 4301070157 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 4301070157 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Beaumont Hospital Royal Oak | Royal oak, MI | Hospital |
| Beaumont Hospital, Troy | Troy, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oakwood Ambulatory Llc | 1850282914 | 258 |
| Entity Name | Oakwood Ambulatory Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003829441 PECOS PAC ID: 1850282914 Enrollment ID: O20040320000401 |
| Entity Name | Michigan Adult & Child Medicine |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174693097 PECOS PAC ID: 9638271505 Enrollment ID: O20070223000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Fuller, 26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849 Ph: () - | Brent Fuller, 3535 W 13 Mile Rd Ste Ll, Royal Oak, MI 48073-6770 Ph: (248) 551-3000 |
Rohma Shamsi, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-551-3850 | |
Nicole Marijanovich, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-898-7999 Fax: 248-898-0580 | |
Vinayata Manuballa Kareti, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 661-948-0803 | |
Christopher Carpenter, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3535 W 13 Mile Rd Ste 605, Royal Oak, MI 48073 Phone: 248-551-0495 | |
Dr. Matthew Burns Cotant, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3577 W 13 Mile Rd, Suite 404, Royal Oak, MI 48073 Phone: 248-551-6900 Fax: 248-551-6909 | |
Taylor Schoenheit, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-898-6509 | |
Shane Mckenna, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-551-3000 Fax: 248-551-9425 |