| Phc Of Michigan, Llc | |
|
35031 23 Mile Rd New Baltimore MI 48047-3649 | |
| (586) 725-5777 | |
| (586) 725-3095 |
| Full Name | Phc Of Michigan, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 35031 23 Mile Rd, New Baltimore, Michigan |
| Authorized Official Name and Position | Brian P Farley (VICE PRESIDENT AND SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phc Of Michigan, Llc 6100 Tower Cir Ste 1000 Franklin TN 37067-1509 Ph: (615) 861-6000 | Phc Of Michigan, Llc 35031 23 Mile Rd New Baltimore MI 48047-3649 Ph: (586) 725-5777 |
| NPI Number | 1396790580 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 7113995085 |
|---|---|
| Medicare Enrollment ID | O20040918000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396790580 | NPI | - | NPPES |
| 001571 | Other | MI | PSYCH CARE |
| 5210664 | Medicaid | MI | |
| 115660 | Other | MI | CARE CHOICES |
| A202377 | Other | MI | VALUE OPTIONS |
| A853975 | Other | MI | VALUE OPTIONS OUTPATIENT CLINIC |
| 260E010270 | Other | MI | BCBSM |
| 5210646 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Michigan) | Primary |
| Provider Name | David K Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497799951 PECOS PAC ID: 9537137195 Enrollment ID: I20040921000951 |
| Provider Name | Sanjeev S Venkataraman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629120282 PECOS PAC ID: 3779599436 Enrollment ID: I20060321000007 |
| Provider Name | James D Adamo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851311021 PECOS PAC ID: 8820047541 Enrollment ID: I20110426000532 |
| Provider Name | Elizabeth A Schnur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740440122 PECOS PAC ID: 7012193899 Enrollment ID: I20181017000417 |
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