| Gino Shwkat Etta, MD | |
|
27351 Dequindre Rd, Madison Heights, MI 48071-3487 | |
| (248) 967-7661 | |
| (248) 967-7876 |
| Full Name | Gino Shwkat Etta |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 7 Years |
| Location | 27351 Dequindre Rd, Madison Heights, 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 |
|---|---|---|---|
| 1194216101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 4301501047 (Michigan) | Secondary |
| 207P00000X | Emergency Medicine | 35.141973 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension Macomb Oakland Hosp-warren Campus | Warren, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Independent Observation Physicians Pllc | 3577603604 | 96 |
| Independent Emergency Physicians Pc | 6709798325 | 122 |
| Entity Name | Independent Emergency Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780791343 PECOS PAC ID: 6709798325 Enrollment ID: O20031103000407 |
| Entity Name | Emergency Department Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225083595 PECOS PAC ID: 9436048998 Enrollment ID: O20040312000466 |
| Entity Name | Independent Observation Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700119500 PECOS PAC ID: 3577603604 Enrollment ID: O20091221000327 |
| Entity Name | Ieppc Urgent Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689235897 PECOS PAC ID: 9032448766 Enrollment ID: O20190905002667 |
| Mailing Address | Practice Location Address |
|---|---|
| Gino Shwkat Etta, MD 27351 Dequindre Rd, Madison Heights, MI 48071-3487 Ph: (248) 967-7661 | Gino Shwkat Etta, MD 27351 Dequindre Rd, Madison Heights, MI 48071-3487 Ph: (248) 967-7661 |
Elizabeth Ann Marcuz, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7000 | |
Kimberly F Heller, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7661 | |
Sergey Tsekhanov, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7795 Fax: 248-967-7794 | |
Matthew Boutorwick, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7795 Fax: 248-967-7794 | |
Jenna Wonsowicz, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7661 Fax: 248-967-7876 | |
Alison Debra-ann Bracken, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 27351 Dequindre Rd, Madison Heights, MI 48071 Phone: 248-967-7795 Fax: 248-967-7794 |