| Andrea Clegg, NP | |
|
22060 Beech St Ste 200, Dearborn, MI 48124-2853 | |
| (313) 228-0505 | |
| (313) 228-0506 |
| Full Name | Andrea Clegg |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 22060 Beech St Ste 200, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285612861 | NPI | - | NPPES |
| P00380696 | Other | RAILROAD MEDICARE | |
| 10-4773390 | Medicaid | MI | |
| 11-4941056 | Medicaid | MI | |
| 10-4773362 | Medicaid | MI | |
| 10-4773371 | Medicaid | MI | |
| 11-4941047 | Medicaid | MI | |
| 5008604240 | Other | MI | BCBS |
| 11-4941038 | Medicaid | MI | |
| 11-4941065 | Medicaid | MI | |
| 10-4773406 | Medicaid | MI | |
| 11712499 | Other | CAQH | |
| 10-4773380 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 4704218011 (Michigan) | Primary |
| Entity Name | Oakwood Ambulatory Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003829441 PECOS PAC ID: 1850282914 Enrollment ID: O20040320000401 |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Clegg, NP 26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849 Ph: () - | Andrea Clegg, NP 22060 Beech St Ste 200, Dearborn, MI 48124-2853 Ph: (313) 228-0505 |
Robin Wawersik, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 18181 Oakwood Blvd Ste 207, Dearborn, MI 48124 Phone: 313-271-5565 Fax: 313-271-1053 | |
Malak Elsabbagh, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4700 Greenfield Rd Ste 2e, Dearborn, MI 48126 Phone: 313-740-1111 | |
Sarah Naji-nehme, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7863 W Morrow Cir, Dearborn, MI 48126 Phone: 313-445-5271 | |
Rana Mazraani, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15400 Michigan Ave, Dearborn, MI 48126 Phone: 313-584-3359 | |
Dr. Fatmeh M Barada, DNP, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5728 Schaefer Rd Ste 103, Dearborn, MI 48126 Phone: 313-581-8080 | |
Ibtihal Alghanimi, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5728 Schaefer Rd Ste 103, Dearborn, MI 48126 Phone: 313-581-8080 | |
Katherine Anne Repp, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 18181 Oakwood Blvd Ste 410, Dearborn, MI 48124 Phone: 313-982-5430 |