| Desir Medical Llc | |
|
6683 Cottonwood Knl W Bloomfield MI 48322-3843 | |
| (313) 720-4254 | |
| Not Available |
| Full Name | Desir Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6683 Cottonwood Knl, W Bloomfield, Michigan |
| Authorized Official Name and Position | Thierry M Desir (OWNER) |
| Authorized Official Contact | 3137204254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desir Medical Llc 6683 Cottonwood Knl W Bloomfield MI 48322-3843 Ph: () - | Desir Medical Llc 6683 Cottonwood Knl W Bloomfield MI 48322-3843 Ph: (313) 720-4254 |
| NPI Number | 1982275723 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 11/30/2021 |
| Medicare PECOS PAC ID | 8921499179 |
|---|---|
| Medicare Enrollment ID | O20220120002747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982275723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Anthony W Clarke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811055858 PECOS PAC ID: 4880618453 Enrollment ID: I20100520000661 |
| Provider Name | Rachel Redman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023763471 PECOS PAC ID: 5395139943 Enrollment ID: I20220225000617 |
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