| Irfan Mamoun, MD | |
|
36175 Harper Ave, Clinton Township, MI 48035-3274 | |
| (586) 741-3772 | |
| Not Available |
| Full Name | Irfan Mamoun |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 51 Years |
| Location | 36175 Harper Ave, Clinton Township, 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 |
|---|---|---|---|
| 1861637811 | NPI | - | NPPES |
| 4301038517 | Other | MI | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME141698 (Florida) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 4301038517 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Josephs Hospital | Tampa, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baycare Outpatient Imaging Llc | 3577804087 | 73 |
| Stern Drake Isbell And Associates Pa | 3779480835 | 65 |
| St Josephs Diagnostic Center Llc | 3779484928 | 83 |
| Entity Name | Stern Drake Isbell & Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215903398 PECOS PAC ID: 3779480835 Enrollment ID: O20031217000029 |
| Entity Name | St Josephs Diagnostic Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558342998 PECOS PAC ID: 3779484928 Enrollment ID: O20040120000332 |
| Entity Name | Baycare Outpatient Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417423377 PECOS PAC ID: 3577804087 Enrollment ID: O20190410002311 |
| Mailing Address | Practice Location Address |
|---|---|
| Irfan Mamoun, MD 22550 Bard Ave, Fairview Park, OH 44126-2907 Ph: (440) 378-4186 | Irfan Mamoun, MD 36175 Harper Ave, Clinton Township, MI 48035-3274 Ph: (586) 741-3772 |
Kyoung Soo Bae, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604 | |
Michael P. Trpkovski, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-464-0740 | |
Cadie Lee Cunningham, Radiology Medicare: Not Enrolled in Medicare Practice Location: 38654 Bay Ln, Clinton Township, MI 48038 Phone: 586-854-2533 | |
Rojanandham Samudrala, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604 | |
Mrs. Cynthia Marie Wheeler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604 | |
Anthony P Munaco, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604 | |
Prof. Victor Maldonado, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604 |