| Poala D Prude-hall, MD | |
|
505 N Clippert St, Lansing Urgent Care, Lansing, MI 48912-4701 | |
| (517) 333-9200 | |
| (517) 333-9201 |
| Full Name | Poala D Prude-hall |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 505 N Clippert St, Lansing, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093889503 | NPI | - | NPPES |
| PP058586 | Other | CHAMPUS-CHAMPUS | |
| PP058586 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
| 327176910 | Medicaid | MI | |
| 080H262390 | Other | BLUE CROSS-BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301058586 (Michigan) | Primary |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Poala D Prude-hall, MD 505 North Clippert, Lansing, MI 48912 Ph: (517) 333-9200 | Poala D Prude-hall, MD 505 N Clippert St, Lansing Urgent Care, Lansing, MI 48912-4701 Ph: (517) 333-9200 |
Daniel Francis Bouchard, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 1215 E Michigan Ave, Osteopathic Internship Sparrow Hospital, Lansing, MI 48912 Phone: 231-955-3360 | |
Dr. Deja Danielle Rice, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: Sparrow Health Systems 1215 E Michigan Avenue, Lansing, MI 48912 Phone: 517-364-5710 | |
Jana Haidar Ahmad, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1215 E Michigan Ave, Lansing, MI 48912 Phone: 517-364-5710 | |
Shimia Isaac, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 E Michigan Ave, Suite 245, Lansing, MI 48912 Phone: 517-364-5772 | |
Katrina Anne Weirauch Engle, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 E Michigan Ave, Suite 245-c, Lansing, MI 48912 Phone: 517-364-5772 Fax: 517-364-5764 | |
David Jonathan Pohl, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1540 Lake Lansing Rd Ste 202, Lansing, MI 48912 Phone: 517-913-3820 Fax: 517-913-3821 | |
Jeffrey Quinn, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1215 E Michigan Ave, Lansing, MI 48912 Phone: 517-364-5710 |