| Berry Johnson Health Pllc | |
|
30123 Rock Creek Dr Southfield MI 48076-5358 | |
| (313) 516-1641 | |
| Not Available |
| Full Name | Berry Johnson Health Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 30123 Rock Creek Dr, Southfield, Michigan |
| Authorized Official Name and Position | Neesha Berry (CO OWNER) |
| Authorized Official Contact | 3135161641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berry Johnson Health Pllc 30123 Rock Creek Dr Southfield MI 48076-5358 Ph: (313) 516-1641 | Berry Johnson Health Pllc 30123 Rock Creek Dr Southfield MI 48076-5358 Ph: (313) 516-1641 |
| NPI Number | 1053910687 |
|---|---|
| Provider Enumeration Date | 10/24/2020 |
| Last Update Date | 10/26/2020 |
| Medicare PECOS PAC ID | 5294141164 |
|---|---|
| Medicare Enrollment ID | O20210302000678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053910687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Neesha Rochelle Berry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134320930 PECOS PAC ID: 1850489105 Enrollment ID: I20071120000291 |
| Provider Name | Nijuanna P Irby-johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366652760 PECOS PAC ID: 3577653401 Enrollment ID: I20071217000071 |
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