| Dr Brooke M Buckley, MD | |
|
2333 Biddle Ave, Wyandotte, MI 48192-4668 | |
| (734) 246-6000 | |
| Not Available |
| Full Name | Dr Brooke M Buckley |
|---|---|
| Gender | Female |
| Speciality | Surgery |
| Location | 2333 Biddle Ave, Wyandotte, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154514602 | NPI | - | NPPES |
| 91645102 | Other | CAREFIRST MARYLAND | |
| 607156013 | Other | DEPT OF LABOR | |
| 413562800 | Medicaid | MD | |
| V7930013 | Other | CAREFIRST DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 4301502392 (Michigan) | Primary |
| 208600000X | Surgery | D0066466 (Maryland) | Secondary |
| Entity Name | Luminis Health Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073580205 PECOS PAC ID: 2860447315 Enrollment ID: O20050317000146 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brooke M Buckley, MD 1 Ford Pl Ste 2e, Detroit, MI 48202-3450 Ph: (313) 874-4806 | Dr Brooke M Buckley, MD 2333 Biddle Ave, Wyandotte, MI 48192-4668 Ph: (734) 246-6000 |
Anthony Campbell, Surgery Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 | |
Dr. Christine Marie Joliat, MD Surgery Medicare: Medicare Enrolled Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Fadi Baidoun, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Suite C, Wyandotte, MI 48192 Phone: 734-324-3330 Fax: 734-324-3303 | |
Jack Avedikian, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Ahmad Abukhader, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 | |
Dr. Marcus Tyler Brown, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-8004 |