| Detroit Wayne County Health Authority | |
|
3031 W Grand Blvd Ste 600 Detroit MI 48202-3014 | |
| (313) 871-3751 | |
| (313) 871-3756 |
| Full Name | Detroit Wayne County Health Authority |
|---|---|
| Speciality | Public Health or Welfare |
| Location | 3031 W Grand Blvd Ste 600, Detroit, Michigan |
| Authorized Official Name and Position | Janette B Davis (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3138713751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Detroit Wayne County Health Authority 3031 W Grand Blvd Ste 600 Detroit MI 48202-3014 Ph: (313) 871-3751 | Detroit Wayne County Health Authority 3031 W Grand Blvd Ste 600 Detroit MI 48202-3014 Ph: (313) 871-3751 |
| NPI Number | 1962733089 |
|---|---|
| Provider Enumeration Date | 01/29/2010 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Medicare PECOS PAC ID | 4385982271 |
|---|---|
| Medicare Enrollment ID | O20190219003271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962733089 | NPI | - | NPPES |
| Provider Name | Kehinde A Ayeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366520470 PECOS PAC ID: 8729073580 Enrollment ID: I20040420000261 |
| Provider Name | Hassan Saghir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730390832 PECOS PAC ID: 0244495018 Enrollment ID: I20120628000233 |
| Provider Name | Ayesha Taj |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801858733 PECOS PAC ID: 1254639412 Enrollment ID: I20160421000723 |
| Provider Name | Mohamed Mosad Almaisari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588248280 PECOS PAC ID: 9638550619 Enrollment ID: I20230117001576 |
| Provider Name | Tiwanna Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003519885 PECOS PAC ID: 0244694651 Enrollment ID: I20230918002184 |
| Provider Name | Christina Ezell Kirkwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497476006 PECOS PAC ID: 5597101766 Enrollment ID: I20240311000605 |
| Provider Name | Robert Warmack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538546775 PECOS PAC ID: 5395111678 Enrollment ID: I20240412003110 |
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