| Simmons Medical Group Pc | |
|
38525 8 Mile Rd Livonia MI 48152-1012 | |
| (734) 542-5512 | |
| Not Available |
| Full Name | Simmons Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 38525 8 Mile Rd, Livonia, Michigan |
| Authorized Official Name and Position | Ian Joshua Tarockoff (VICE PRESIDENT) |
| Authorized Official Contact | 7345425512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simmons Medical Group Pc 38525 8 Mile Rd Livonia MI 48152-1012 Ph: (734) 542-5512 | Simmons Medical Group Pc 38525 8 Mile Rd Livonia MI 48152-1012 Ph: (734) 542-5512 |
| NPI Number | 1114324969 |
|---|---|
| Provider Enumeration Date | 11/21/2014 |
| Last Update Date | 01/28/2021 |
| Certification Date | 01/28/2021 |
| Medicare PECOS PAC ID | 7416271796 |
|---|---|
| Medicare Enrollment ID | O20150114001412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114324969 | NPI | - | NPPES |
| Provider Name | Keith J Pierce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184790495 PECOS PAC ID: 9830083013 Enrollment ID: I20040210000050 |
| Provider Name | Mirella F Ducu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528136066 PECOS PAC ID: 8527059575 Enrollment ID: I20040519001267 |
| Provider Name | Andrew Jay Borin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346212800 PECOS PAC ID: 1052390267 Enrollment ID: I20040720000168 |
| Provider Name | Tracey A Haener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295709103 PECOS PAC ID: 2264475573 Enrollment ID: I20050608000115 |
| Provider Name | Mahnaz S Mafee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063520211 PECOS PAC ID: 4981603222 Enrollment ID: I20061213000504 |
| Provider Name | Ali F Mafee |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588616650 PECOS PAC ID: 9830266915 Enrollment ID: I20080916000576 |
| Provider Name | Ali Ghasham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881894459 PECOS PAC ID: 9931379864 Enrollment ID: I20110831000553 |
| Provider Name | Margaret D Barden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063840601 PECOS PAC ID: 8527296490 Enrollment ID: I20140123000272 |
| Provider Name | John S Maarouf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497174478 PECOS PAC ID: 1658679972 Enrollment ID: I20160419002401 |
| Provider Name | Toni Marie Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821457615 PECOS PAC ID: 4284923285 Enrollment ID: I20160513001972 |
| Provider Name | Klajdi Ndini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891239026 PECOS PAC ID: 7214210061 Enrollment ID: I20170202000052 |
| Provider Name | Jordan T Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073058475 PECOS PAC ID: 6800170416 Enrollment ID: I20170227002388 |
| Provider Name | Leah Flanigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669993614 PECOS PAC ID: 7416228192 Enrollment ID: I20170731001780 |
| Provider Name | Bethany A Stallings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790295004 PECOS PAC ID: 7214296557 Enrollment ID: I20180112002389 |
| Provider Name | Tonya Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801327507 PECOS PAC ID: 2163799792 Enrollment ID: I20180228001248 |
| Provider Name | Alexandrina Berghian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609384569 PECOS PAC ID: 2769747658 Enrollment ID: I20180524000159 |
| Provider Name | Latanya Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396140372 PECOS PAC ID: 0143564658 Enrollment ID: I20181210001575 |
| Provider Name | Victor Harrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922409002 PECOS PAC ID: 2264762871 Enrollment ID: I20190925000723 |
| Provider Name | Robert T Louis-ferdinand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548802713 PECOS PAC ID: 0547480642 Enrollment ID: I20191220000741 |
| Provider Name | Ashley Jeanne White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750855136 PECOS PAC ID: 8628409935 Enrollment ID: I20200520000947 |
| Provider Name | Amina Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295336964 PECOS PAC ID: 1254746522 Enrollment ID: I20210218001528 |
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