| Intervisions Pc | |
|
20811 Kelly Eastpointe MI 48021 | |
| (586) 445-3612 | |
| (586) 445-0700 |
| Full Name | Intervisions Pc |
|---|---|
| Speciality | Psychologist |
| Location | 20811 Kelly, Eastpointe, Michigan |
| Authorized Official Name and Position | Charles Raymond Stern (PSYCHOLOGIST) |
| Authorized Official Contact | 5864453612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intervisions Pc 1839 Shipman Birmingham MI 48009 Ph: (586) 445-3612 | Intervisions Pc 20811 Kelly Eastpointe MI 48021 Ph: (586) 445-3612 |
| NPI Number | 1730243262 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 03/05/2008 |
| Medicare PECOS PAC ID | 9739265760 |
|---|---|
| Medicare Enrollment ID | O20080331000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730243262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301005261 (Michigan) | Primary |
| Provider Name | Charles R Stern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952400848 PECOS PAC ID: 0749366763 Enrollment ID: I20080331000318 |
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