| Annapolis Medical Center | |
|
4811 Venoy Rd Ste B Wayne MI 48184-2675 | |
| (313) 415-5254 | |
| Not Available |
| Full Name | Annapolis Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4811 Venoy Rd Ste B, Wayne, Michigan |
| Authorized Official Name and Position | Ahmad Youssef (CEO) |
| Authorized Official Contact | 3134155254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Annapolis Medical Center 212 Cherry Ln Inkster MI 48141-1499 Ph: () - | Annapolis Medical Center 4811 Venoy Rd Ste B Wayne MI 48184-2675 Ph: (313) 415-5254 |
| NPI Number | 1497202253 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 09/08/2016 |
| Medicare PECOS PAC ID | 1153617238 |
|---|---|
| Medicare Enrollment ID | O20160916000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497202253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5101021767 (Michigan) | Primary |
| Provider Name | Ahmad A Youssef |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144602285 PECOS PAC ID: 8527377795 Enrollment ID: I20160916000231 |
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