| Pro-health Medical Fp | |
|
3003 S Baldwin Rd Ste B Lake Orion MI 48359-2358 | |
| (248) 301-1090 | |
| Not Available |
| Full Name | Pro-health Medical Fp |
|---|---|
| Speciality | Clinic/Center |
| Location | 3003 S Baldwin Rd Ste B, Lake Orion, Michigan |
| Authorized Official Name and Position | Steve Greene (PRESIDENT) |
| Authorized Official Contact | 2483011090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro-health Medical Fp 3003 S Baldwin Rd Ste B Lake Orion MI 48359-2358 Ph: () - | Pro-health Medical Fp 3003 S Baldwin Rd Ste B Lake Orion MI 48359-2358 Ph: (248) 301-1090 |
| NPI Number | 1740841451 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 0042642407 |
|---|---|
| Medicare Enrollment ID | O20191123000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740841451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Robert L Chadwick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740220870 PECOS PAC ID: 8921057621 Enrollment ID: I20050120000322 |
| Provider Name | Eileen F Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487844122 PECOS PAC ID: 7113091505 Enrollment ID: I20080802000035 |
| Provider Name | Nick S Buttar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326085861 PECOS PAC ID: 5092844316 Enrollment ID: I20100525000985 |
| Provider Name | Mariana L Perinot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740591908 PECOS PAC ID: 0143462705 Enrollment ID: I20130809000552 |
| Provider Name | Sabrina Vitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699276295 PECOS PAC ID: 6507111523 Enrollment ID: I20180615000955 |
| Provider Name | Carrie L Kovolski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194366195 PECOS PAC ID: 9931538196 Enrollment ID: I20200409000829 |
| Provider Name | Emily Grout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265058390 PECOS PAC ID: 3072931393 Enrollment ID: I20200917001450 |
| Provider Name | Faith Jurges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043978588 PECOS PAC ID: 4688068331 Enrollment ID: I20220223002292 |
| Provider Name | Angela Rosalie Bucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821721838 PECOS PAC ID: 6608258207 Enrollment ID: I20220728003001 |
| Provider Name | Amanda Leigh Laur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093433500 PECOS PAC ID: 2567832330 Enrollment ID: I20230112001553 |
| Provider Name | Jessica Lynne Naismith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518678473 PECOS PAC ID: 3476925132 Enrollment ID: I20230207002419 |
| Provider Name | Eric David Strother |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396450383 PECOS PAC ID: 1355714189 Enrollment ID: I20230227001318 |
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