| Dr Wala Clinic | |
|
106 S Lowe St Dowagiac MI 49047-1624 | |
| (574) 335-9177 | |
| Not Available |
| Full Name | Dr Wala Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 106 S Lowe St, Dowagiac, Michigan |
| Authorized Official Name and Position | Mohammed Amjad Ranginwala (OWNER) |
| Authorized Official Contact | 5743359177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wala Clinic 14360 Wynstone Ct Granger IN 46530-4202 Ph: (574) 335-9177 | Dr Wala Clinic 106 S Lowe St Dowagiac MI 49047-1624 Ph: (574) 335-9177 |
| NPI Number | 1548607039 |
|---|---|
| Provider Enumeration Date | 05/24/2013 |
| Last Update Date | 05/24/2013 |
| Medicare PECOS PAC ID | 3779726518 |
|---|---|
| Medicare Enrollment ID | O20130827000574 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548607039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301088022 (Michigan) | Primary |
| Provider Name | Mohammed a Ranginwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154480994 PECOS PAC ID: 6406950948 Enrollment ID: I20070322000536 |
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