| Jimmy Charbel Haouilou, MD | |
|
25350 Kelly Rd, Roseville, MI 48066-5824 | |
| (586) 270-5100 | |
| (586) 270-5111 |
| Full Name | Jimmy Charbel Haouilou |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 23 Years |
| Location | 25350 Kelly Rd, Roseville, 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 |
|---|---|---|---|
| 1063676286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 4301084691 (Michigan) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 4301084691 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension St John Hospital | Detroit, MI | Hospital |
| Beaumont Hospital - Grosse Pointe | Grosse pointe, MI | Hospital |
| Ascension Macomb Oakland Hosp-warren Campus | Warren, MI | Hospital |
| Ascension River District Hospital | East china, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Vascular Associates Pllc | 0042430548 | 3 |
| Entity Name | Premier Vascular Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972904951 PECOS PAC ID: 0042430548 Enrollment ID: O20141006000508 |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Jimmy Charbel Haouilou, MD 25350 Kelly Rd, Roseville, MI 48066-5824 Ph: (586) 270-5100 | Jimmy Charbel Haouilou, MD 25350 Kelly Rd, Roseville, MI 48066-5824 Ph: (586) 270-5100 |
Luis Barbe, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 25990 Kelly Rd, Suite 1, Roseville, MI 48066 Phone: 586-445-0950 Fax: 586-445-9866 | |
Mr. Francisco J Rodriguez, MD, P.C. Surgery Medicare: Not Enrolled in Medicare Practice Location: 25710 Kelly Rd, Suite 2, Roseville, MI 48066 Phone: 586-445-8030 Fax: 586-445-8156 | |
Jeffrey Maurice Hall, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 18245 E 10 Mile Rd, Suite 130, Roseville, MI 48066 Phone: 586-774-4200 Fax: 586-774-4201 |