Baco Care Services Llc | |
26901 Beaumont Blvd Southfield MI 48033-3849 | |
(947) 522-0031 | |
Not Available |
Full Name | Baco Care Services Llc |
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Speciality | Internal Medicine |
Location | 26901 Beaumont Blvd, Southfield, Michigan |
Authorized Official Name and Position | Walter Lorang (CEO) |
Authorized Official Contact | 9475220037 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Baco Care Services Llc 26901 Beaumont Blvd Southfield MI 48033-3849 Ph: (947) 522-0031 | Baco Care Services Llc 26901 Beaumont Blvd Southfield MI 48033-3849 Ph: (947) 522-0031 |
NPI Number | 1780294850 |
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Provider Enumeration Date | 08/04/2020 |
Last Update Date | 10/23/2022 |
Medicare PECOS PAC ID | 6103286737 |
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Medicare Enrollment ID | O20230714000925 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780294850 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Fathelrahman O Ali |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326018748 PECOS PAC ID: 4284627233 Enrollment ID: I20040406000263 |
Provider Name | Halima S Ali |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194796383 PECOS PAC ID: 7719970771 Enrollment ID: I20040406000293 |
Provider Name | Ghadi Gabriel Ghorayeb |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932158425 PECOS PAC ID: 0244208882 Enrollment ID: I20040921000789 |
Provider Name | Christopher R Deangelis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629076450 PECOS PAC ID: 1254416324 Enrollment ID: I20080313000300 |
Provider Name | Juan A Estigarribia |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336111517 PECOS PAC ID: 4183701014 Enrollment ID: I20080402000790 |
Provider Name | Stephen A Williams |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1962464982 PECOS PAC ID: 6608909932 Enrollment ID: I20100806000086 |
Provider Name | Clara Kamath-wood |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548377328 PECOS PAC ID: 4486651254 Enrollment ID: I20100812000496 |
Provider Name | Fuad M Rahimee |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659510881 PECOS PAC ID: 3678742590 Enrollment ID: I20110811000052 |
Provider Name | Sarah E Wilson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275797946 PECOS PAC ID: 5294905956 Enrollment ID: I20110907001162 |
Provider Name | Usman Ahmed |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043507049 PECOS PAC ID: 0143450205 Enrollment ID: I20140311001650 |
Provider Name | Marcelli Jade Gayonoche Contreras |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033496955 PECOS PAC ID: 1052606969 Enrollment ID: I20160817000049 |
Provider Name | Rabia Chaudry |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306251608 PECOS PAC ID: 0042521585 Enrollment ID: I20180312000358 |
Provider Name | Naiff Ali |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992151401 PECOS PAC ID: 4284924101 Enrollment ID: I20200720000093 |
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