| Alfonso Acosta Md Pc | |
|
7173 Ilanaway Dr W Bloomfield MI 48324-2493 | |
| (586) 929-0842 | |
| (248) 366-0065 |
| Full Name | Alfonso Acosta Md Pc |
|---|---|
| Speciality | General Practice |
| Location | 7173 Ilanaway Dr, W Bloomfield, Michigan |
| Authorized Official Name and Position | Alfonso Acosta (PRESIDENT) |
| Authorized Official Contact | 5869290842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alfonso Acosta Md Pc Po Box 250433 W Bloomfield MI 48325-0433 Ph: (586) 929-0842 | Alfonso Acosta Md Pc 7173 Ilanaway Dr W Bloomfield MI 48324-2493 Ph: (586) 929-0842 |
| NPI Number | 1184881971 |
|---|---|
| Provider Enumeration Date | 05/20/2008 |
| Last Update Date | 05/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184881971 | NPI | - | NPPES |
| P00193884 | Other | RAILROAD MEDICARE | |
| 103522994 | Medicaid | MI | |
| 1106335602 | Other | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301064369 (Michigan) | Primary |
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