| Amethyst Medical Offices Plc | |
|
3741 Mcdougall St Suite 2 Detroit MI 48207-2345 | |
| (313) 921-4327 | |
| (313) 921-3628 |
| Full Name | Amethyst Medical Offices Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3741 Mcdougall St, Detroit, Michigan |
| Authorized Official Name and Position | Alexa Joshua (FOUNDER PRESIDENT) |
| Authorized Official Contact | 3139214327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amethyst Medical Offices Plc 8200 E Jefferson Ave Apt 709 Detroit MI 48214-3974 Ph: (313) 822-0308 | Amethyst Medical Offices Plc 3741 Mcdougall St Suite 2 Detroit MI 48207-2345 Ph: (313) 921-4327 |
| NPI Number | 1699813006 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092811000 |
|---|---|
| Medicare Enrollment ID | O20070509000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699813006 | NPI | - | NPPES |
| 4241290 | Medicaid | MI | |
| 1699869438 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301406975 (Michigan) | Primary |
| Provider Name | Alexa Joshua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699869438 PECOS PAC ID: 0648376657 Enrollment ID: I20070509000045 |
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