| East Michigan Infectious Disease Pllc | |
|
1375 N Main St Lapeer MI 48446-1350 | |
| (248) 760-5812 | |
| Not Available |
| Full Name | East Michigan Infectious Disease Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1375 N Main St, Lapeer, Michigan |
| Authorized Official Name and Position | Elfatih Abter (PRESIDENT) |
| Authorized Official Contact | 2487605812 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Michigan Infectious Disease Pllc Po Box 14 Oxford MI 48371-0014 Ph: (248) 760-5812 | East Michigan Infectious Disease Pllc 1375 N Main St Lapeer MI 48446-1350 Ph: (248) 760-5812 |
| NPI Number | 1346554359 |
|---|---|
| Provider Enumeration Date | 08/02/2010 |
| Last Update Date | 11/27/2012 |
| Medicare PECOS PAC ID | 0244419877 |
|---|---|
| Medicare Enrollment ID | O20110127000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346554359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 4301089652 (Michigan) | Primary |
| Provider Name | Tracey A Haener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295709103 PECOS PAC ID: 2264475573 Enrollment ID: I20050608000115 |
| Provider Name | Elfatih Ismail I M Abter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255473534 PECOS PAC ID: 7618075375 Enrollment ID: I20070605000163 |
| Provider Name | Traci Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164824892 PECOS PAC ID: 0244553253 Enrollment ID: I20141224001082 |
| Provider Name | Jessica Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043785165 PECOS PAC ID: 8123369253 Enrollment ID: I20190417002792 |
| Provider Name | Siham Mahgoub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194834754 PECOS PAC ID: 5991886194 Enrollment ID: I20190906002016 |
| Provider Name | Amorena L Tompkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952861874 PECOS PAC ID: 0840628590 Enrollment ID: I20200312000789 |
| Provider Name | Cori C Wirth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275121675 PECOS PAC ID: 1456769660 Enrollment ID: I20210427002245 |
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