| Family Docs Clinic | |
|
8275 Holly Rd Suite 1 Grand Blanc MI 48439-2442 | |
| (810) 603-0990 | |
| (810) 603-1678 |
| Full Name | Family Docs Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 8275 Holly Rd, Grand Blanc, Michigan |
| Authorized Official Name and Position | Evtishios James Daros (PRESIDENT) |
| Authorized Official Contact | 8106030990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Docs Clinic 8275 Holly Rd Suite 1 Grand Blanc MI 48439-2442 Ph: (810) 603-0990 | Family Docs Clinic 8275 Holly Rd Suite 1 Grand Blanc MI 48439-2442 Ph: (810) 603-0990 |
| NPI Number | 1902029713 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 05/21/2020 |
| Medicare PECOS PAC ID | 6406849637 |
|---|---|
| Medicare Enrollment ID | O20040405001115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902029713 | NPI | - | NPPES |
| 1003800350 | Other | MI | NPI INDIVIDUAL |
| 4614320 | Medicaid | MI | |
| ED007048 | Other | MI | STATE LICENSE NUMBER |
| 080B511230 | Other | MI | BCBSM |
| DM076048 | Other | MI | STATE LICENSE NUMBER |
| $$$$$$$$$ | Other | MI | SSN |
| AD013144 | Other | MI | STATE LICENSE NUMBER |
| 1316944333 | Other | MI | NPI INDIVIDUAL |
| 1841284437 | Other | MI | NPI INDIVIDUAL |
| $$$$$$$$$ | Other | MI | SSN |
| 2095522 | Medicaid | MI | |
| 4613396 | Medicaid | MI | |
| $$$$$$$$$ | Other | MI | SSN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ED007048 (Michigan) | Primary |
| Provider Name | Antony J Daros |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003800350 PECOS PAC ID: 2668549700 Enrollment ID: I20080916000193 |
| Provider Name | Evtishios J Daros |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316944333 PECOS PAC ID: 1658364880 Enrollment ID: I20100729000584 |
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