| Dr Lakshmi Hanasoge, MD | |
|
15555 Northline Rd, Southgate, MI 48195-1896 | |
| (734) 285-3090 | |
| (734) 285-3095 |
| Full Name | Dr Lakshmi Hanasoge |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 15555 Northline Rd, Southgate, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568545077 | NPI | - | NPPES |
| LH072903 | Other | MI | BLUE CROSS MI LICENSE |
| 000000000943 | Other | MI | CAPE HEALTH PLAN |
| 4492610 | Medicaid | MI | |
| B43221 | Other | MI | HA |
| 023843 | Other | MI | MIDWEST HEALTH PLAN |
| 16298 | Other | MI | MCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 4310172903 (Michigan) | Primary |
| Entity Name | The Cleveland Clinic Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679525919 PECOS PAC ID: 1850203555 Enrollment ID: O20031103000049 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lakshmi Hanasoge, MD 15555 Northline Rd, Southgate, MI 48195-1896 Ph: (734) 285-3090 | Dr Lakshmi Hanasoge, MD 15555 Northline Rd, Southgate, MI 48195-1896 Ph: (734) 285-3090 |
Jason William Bihn, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15350 Trenton Rd, Southgate, MI 48195 Phone: 734-283-4616 Fax: 734-283-5430 | |
Dr. Jurin Boriboon, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15350 Trenton Rd, Southgate, MI 48195 Phone: 734-283-4616 Fax: 734-283-5430 | |
Dr. Brenden Bisson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 15555 Northline Rd, Southgate, MI 48195 Phone: 734-285-3090 | |
Joan Less, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15777 Northline Rd, Southgate, MI 48195 Phone: 734-246-8100 | |
Hirut Dagnew, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 15777 Northline Rd, Southgate, MI 48195 Phone: 734-246-8100 | |
Dr. Dinesh Nayak, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 15555 Northline Rd, Southgate, MI 48195 Phone: 734-285-3090 Fax: 734-285-3095 |