| Elite Prime Care PLLC | |
|
8542 N Canton Center Rd Canton MI 48187-1310 | |
| (734) 455-8310 | |
| (313) 337-8984 |
| Full Name | Elite Prime Care PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 8542 N Canton Center Rd, Canton, Michigan |
| Authorized Official Name and Position | Mohamed Nasser (MANAGING DIRECTOR) |
| Authorized Official Contact | 3132072460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Prime Care PLLC 22335 Waterland Dr Northville MI 48167-3500 Ph: (313) 207-2460 | Elite Prime Care PLLC 8542 N Canton Center Rd Canton MI 48187-1310 Ph: (734) 455-8310 |
| NPI Number | 1104542828 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Medicare PECOS PAC ID | 6709253669 |
|---|---|
| Medicare Enrollment ID | O20221104002455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104542828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Fares N Mubarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831753466 PECOS PAC ID: 4688917305 Enrollment ID: I20190521002932 |
| Provider Name | Mohamed M Nasser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558890277 PECOS PAC ID: 3577832245 Enrollment ID: I20211229000382 |
| Provider Name | Sukhwinder Kaur Pabla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871226043 PECOS PAC ID: 9234594557 Enrollment ID: I20230420000921 |
| Provider Name | Corie Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104352582 PECOS PAC ID: 0941577456 Enrollment ID: I20230508000469 |
| Provider Name | Ashraf Abouarabi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831883446 PECOS PAC ID: 3678933132 Enrollment ID: I20230714002696 |
| Provider Name | Noveen Rehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831883420 PECOS PAC ID: 5799123329 Enrollment ID: I20240402002675 |
| Provider Name | Brian Benenati |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750065033 PECOS PAC ID: 5092173906 Enrollment ID: I20260605000956 |
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