| Ch Mssp Services Mi Pllc | |
|
400 Renaissance Ctr Ste 2600 Detroit MI 48243-1599 | |
| (337) 991-9276 | |
| Not Available |
| Full Name | Ch Mssp Services Mi Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 Renaissance Ctr Ste 2600, Detroit, Michigan |
| Authorized Official Name and Position | Nicole Howard (SR VP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Mssp Services Mi Pllc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 991-9276 | Ch Mssp Services Mi Pllc 400 Renaissance Ctr Ste 2600 Detroit MI 48243-1599 Ph: (337) 991-9276 |
| NPI Number | 1609569169 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 05/31/2023 |
| Medicare PECOS PAC ID | 2961862800 |
|---|---|
| Medicare Enrollment ID | O20230724002653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609569169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lynda L Hulst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811942519 PECOS PAC ID: 6305875881 Enrollment ID: I20050804000896 |
| Provider Name | Gary S Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205839909 PECOS PAC ID: 1254243785 Enrollment ID: I20051108000095 |
| Provider Name | Lauren E Taboh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093083743 PECOS PAC ID: 5799948733 Enrollment ID: I20120531000427 |
| Provider Name | Julie M Walwyn Tross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427497957 PECOS PAC ID: 7719111715 Enrollment ID: I20131007000382 |
| Provider Name | Amanda M Yuchasz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427483338 PECOS PAC ID: 3476781808 Enrollment ID: I20140110000936 |
| Provider Name | Maath Alani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518250133 PECOS PAC ID: 6800011677 Enrollment ID: I20140710002452 |
| Provider Name | Carole Lenzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881061497 PECOS PAC ID: 2961711403 Enrollment ID: I20151022002168 |
| Provider Name | Marielle Elliot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508369752 PECOS PAC ID: 4284988908 Enrollment ID: I20181116000346 |
| Provider Name | Christopher Elliot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194207548 PECOS PAC ID: 3274877691 Enrollment ID: I20181211002950 |
| Provider Name | Laura Leske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427549583 PECOS PAC ID: 2567704323 Enrollment ID: I20190425002762 |
| Provider Name | Melissa Marie Rife |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184256380 PECOS PAC ID: 1355762287 Enrollment ID: I20200602001511 |
| Provider Name | Kelly J Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336814490 PECOS PAC ID: 4082010806 Enrollment ID: I20210902001422 |
| Provider Name | Dominique Pinilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124103965 PECOS PAC ID: 4880604446 Enrollment ID: I20210923001053 |
| Provider Name | Joysie Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295497436 PECOS PAC ID: 8325437692 Enrollment ID: I20211109000453 |
| Provider Name | Gwendolyn Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992390157 PECOS PAC ID: 6406248673 Enrollment ID: I20220120000672 |
| Provider Name | Shannetta L Houze-dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891449930 PECOS PAC ID: 1355735093 Enrollment ID: I20220223002038 |
| Provider Name | Renee Kinaia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073028130 PECOS PAC ID: 3274927694 Enrollment ID: I20220301002431 |
| Provider Name | Siddeequa Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124624465 PECOS PAC ID: 8426431362 Enrollment ID: I20220810002048 |
| Provider Name | Jie Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396340915 PECOS PAC ID: 4486069523 Enrollment ID: I20230110002912 |
| Provider Name | Jennifer Lynn Frey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437667946 PECOS PAC ID: 3173995495 Enrollment ID: I20230215002006 |
| Provider Name | Antonio Gamboa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154356780 PECOS PAC ID: 2264468222 Enrollment ID: I20230526001424 |
| Provider Name | Tina Shenouda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326386996 PECOS PAC ID: 9537397872 Enrollment ID: I20230712000356 |
| Provider Name | Nina Bryhn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811676430 PECOS PAC ID: 4688568728 Enrollment ID: I20231011002418 |
| Provider Name | Ashley R Tolliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578348322 PECOS PAC ID: 8820444185 Enrollment ID: I20231024001400 |
| Provider Name | Elizabeth Anne Burkart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801659891 PECOS PAC ID: 6204270275 Enrollment ID: I20240217000298 |
| Provider Name | James Woody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144705955 PECOS PAC ID: 5799029062 Enrollment ID: I20240305003105 |
Smith Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7800 W Outer Dr, Suite 230, Detroit, MI 48235 Phone: 313-535-0900 Fax: 313-535-3810 | |
St. John Hospital And Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 586-753-0011 | |
Community Health And Social Services Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3426 Mack Avenue, Detroit, MI 48207 Phone: 313-849-3920 | |
Health Care Medical Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17141 Hayes St, Detroit, MI 48205 Phone: 313-245-1700 Fax: 313-245-1701 | |
Mizrahi Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7633 E Jefferson Ave Ste 250, Detroit, MI 48214 Phone: 313-821-3338 Fax: 313-823-5363 | |
T L Sea Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15201 W Mcnichols Rd, Detroit, MI 48235 Phone: 313-516-3142 | |
Community Health And Social Services Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 882 Oakman Blvd, Detroit, MI 48238 Phone: 313-849-3920 Fax: 313-849-0824 |