| Ala E. Imam, M.d., P.c. | |
|
6770 Dixie Hwy Suite 301 Clarkston MI 48346-2087 | |
| (248) 625-3000 | |
| (248) 623-2278 |
| Full Name | Ala E. Imam, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6770 Dixie Hwy, Clarkston, Michigan |
| Authorized Official Name and Position | Ala E Imam (PRESIDENT) |
| Authorized Official Contact | 2486253000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ala E. Imam, M.d., P.c. 6770 Dixie Hwy Suite 301 Clarkston MI 48346-2087 Ph: (248) 625-3000 | Ala E. Imam, M.d., P.c. 6770 Dixie Hwy Suite 301 Clarkston MI 48346-2087 Ph: (248) 625-3000 |
| NPI Number | 1295900975 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Medicare PECOS PAC ID | 7618046004 |
|---|---|
| Medicare Enrollment ID | O20080527000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295900975 | NPI | - | NPPES |
| 139592710 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Ala E Imam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588742878 PECOS PAC ID: 7618046095 Enrollment ID: I20080527000759 |
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