| Markeeta West, | |
|
15777 Northline Rd Ste 200, Southgate, MI 48195-2354 | |
| (734) 246-8100 | |
| Not Available |
| Full Name | Markeeta West |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 15777 Northline Rd Ste 200, 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 |
|---|---|---|---|
| 1598980567 | NPI | - | NPPES |
| SC99843365 | Other | SC | MEDICARE PIN |
| SC99845019 | Other | SC | MEDICARE PIN |
| 341767 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 2009-01209 (North Carolina) | Secondary |
| 208000000X | Pediatrics | 34176 (South Carolina) | Secondary |
| 208000000X | Pediatrics | 4301085607 (Michigan) | Primary |
| Entity Name | Oakwood Ambulatory Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003829441 PECOS PAC ID: 1850282914 Enrollment ID: O20040320000401 |
| Mailing Address | Practice Location Address |
|---|---|
| Markeeta West, 26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849 Ph: (947) 522-1848 | Markeeta West, 15777 Northline Rd Ste 200, Southgate, MI 48195-2354 Ph: (734) 246-8100 |
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 | |
Dr. Lakshmi Hanasoge, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 15555 Northline Rd, Southgate, MI 48195 Phone: 734-285-3090 Fax: 734-285-3095 |