| Envision Medical Group Pllc | |
|
12660 Ten Mile Rd South Lyon MI 48178-9141 | |
| (248) 348-1131 | |
| Not Available |
| Full Name | Envision Medical Group Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 12660 Ten Mile Rd, South Lyon, Michigan |
| Authorized Official Name and Position | Michael Wayne (MANAGING MEMBER) |
| Authorized Official Contact | 2483488700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Envision Medical Group Pllc 27275 Haggerty Rd Ste 500 Novi MI 48377-3635 Ph: (248) 741-6901 | Envision Medical Group Pllc 12660 Ten Mile Rd South Lyon MI 48178-9141 Ph: (248) 348-1131 |
| NPI Number | 1003125774 |
|---|---|
| Provider Enumeration Date | 09/29/2010 |
| Last Update Date | 02/23/2021 |
| Medicare PECOS PAC ID | 0840315867 |
|---|---|
| Medicare Enrollment ID | O20130321000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003125774 | NPI | - | NPPES |
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