Latisha M Malcom, MD in Inkster, MI - Medicare Internal Medicine

Latisha M Malcom, MD is a medicare enrolled "Internal Medicine" physician in Inkster, Michigan. She went to Wayne State University School Of Medicine and graduated in 1997 and has 29 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Western Wayne Family Health Centers and her current practice location is 2700 Hamlin Blvd, Inkster, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 561-5100.

Latisha M Malcom is licensed to practice in Michigan (license number 4301070929) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114999430.

Contact Information

	Latisha M Malcom, MD
	2700 Hamlin Blvd, Inkster, MI 48141-2206
	(313) 561-5100
	(313) 565-0309

Map and Direction

Physician's Profile

Full Name	Latisha M Malcom
Gender	Female
Speciality	Internal Medicine
Experience	29 Years
Location	2700 Hamlin Blvd, Inkster, Michigan
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Latisha M Malcom attended and graduated from Wayne State University School Of Medicine in 1997

NPI Data:

NPI Number: 1114999430
Provider Enumeration Date: 02/02/2006
Last Update Date: 03/25/2026

Medicare PECOS Information:

PECOS PAC ID: 2466427547
Enrollment ID: I20040901000249

Medical Identifiers

Medical identifiers for Latisha M Malcom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114999430	NPI	-	NPPES
4604232-10	Medicaid	MI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	4301070929 (Michigan)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Beaumont Hospital - Wayne	Wayne, MI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Western Wayne Family Health Centers	4082617998	17

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Latisha M Malcom allows following entities to bill medicare on her behalf.

Entity Name	Western Wayne Family Health Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972530277 PECOS PAC ID: 4082617998 Enrollment ID: O20060926000287

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latisha M Malcom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Latisha M Malcom, MD 2700 Hamlin Blvd, Inkster, MI 48141-2206 Ph: (313) 561-5100	Latisha M Malcom, MD 2700 Hamlin Blvd, Inkster, MI 48141-2206 Ph: (313) 561-5100

Latisha M Malcom, MD - Medicare Internal Medicine in Inkster, MI