| A3 Medical | |
|
4050 W Maple Road Suite 101 Bloomfield MI 48301 | |
| (248) 885-8211 | |
| (248) 855-8357 |
| Full Name | A3 Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 4050 W Maple Road, Bloomfield, Michigan |
| Authorized Official Name and Position | Supak Sookkasikon (NOT APPLICABLE) |
| Authorized Official Contact | 2488858211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A3 Medical 4050 W Maple Road Suite 101 Bloomfield MI 48301 Ph: (248) 885-8211 | A3 Medical 4050 W Maple Road Suite 101 Bloomfield MI 48301 Ph: (248) 885-8211 |
| NPI Number | 1366798373 |
|---|---|
| Provider Enumeration Date | 07/27/2012 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Medicare PECOS PAC ID | 7315183076 |
|---|---|
| Medicare Enrollment ID | O20130425000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366798373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301083253 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 4301080609 (Michigan) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | Kristina Camaj |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801834478 PECOS PAC ID: 3173595741 Enrollment ID: I20040812000991 |
| Provider Name | Jennifer L Ruel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811975022 PECOS PAC ID: 9931162815 Enrollment ID: I20041111000180 |
| Provider Name | Manish Naran Kesliker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639121841 PECOS PAC ID: 3173540812 Enrollment ID: I20051101000434 |
| Provider Name | Supak Sookkasikon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649376922 PECOS PAC ID: 9537263132 Enrollment ID: I20070409000031 |
| Provider Name | Azrael a Paredes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518197029 PECOS PAC ID: 3678722386 Enrollment ID: I20121012000113 |
| Provider Name | Anna M Farhat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710241856 PECOS PAC ID: 4981917937 Enrollment ID: I20150720001750 |
Muthanna Louis MD PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7455 Glengrove Dr, Bloomfield, MI 48301 Phone: 248-798-7727 |
Nidhi Shishu Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4521 River Trl, Bloomfield, MI 48301 Phone: 248-840-8289 |