| A. Peter Evangelista, Md, Pc | |
|
10475 Farmington Rd Livonia MI 48150-5704 | |
| (734) 427-9440 | |
| (734) 427-1071 |
| Full Name | A. Peter Evangelista, Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10475 Farmington Rd, Livonia, Michigan |
| Authorized Official Name and Position | Augustus Peter Evangelista (CEO) |
| Authorized Official Contact | 2486260470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A. Peter Evangelista, Md, Pc 7071 Orchard Lake Rd Suite 333 West Bloomfield MI 48322-3613 Ph: (248) 626-0470 | A. Peter Evangelista, Md, Pc 10475 Farmington Rd Livonia MI 48150-5704 Ph: (734) 427-9440 |
| NPI Number | 1538616008 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Medicare PECOS PAC ID | 0446538581 |
|---|---|
| Medicare Enrollment ID | O20161025001808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538616008 | NPI | - | NPPES |
| 4301108922 | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301108922 (Michigan) | Primary |
| Provider Name | Augustus P Evangelista |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386922193 PECOS PAC ID: 7012168453 Enrollment ID: I20161025001451 |
| Provider Name | Kathleen M Naski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366911737 PECOS PAC ID: 9234474628 Enrollment ID: I20181212002111 |
| Provider Name | Diana C Lengel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346569886 PECOS PAC ID: 9739502709 Enrollment ID: I20200709000420 |
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