| Great Lakes Urgent Care Pc Of Eastside | |
|
19070 E 10 Mile Rd Eastpointe MI 48021-1449 | |
| (586) 773-1383 | |
| (586) 773-1385 |
| Full Name | Great Lakes Urgent Care Pc Of Eastside |
|---|---|
| Speciality | Internal Medicine |
| Location | 19070 E 10 Mile Rd, Eastpointe, Michigan |
| Authorized Official Name and Position | Fuad M Rahimee (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5867731383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Urgent Care Pc Of Eastside 19070 E 10 Mile Rd Eastpointe MI 48021-1449 Ph: (586) 773-1383 | Great Lakes Urgent Care Pc Of Eastside 19070 E 10 Mile Rd Eastpointe MI 48021-1449 Ph: (586) 773-1383 |
| NPI Number | 1477978930 |
|---|---|
| Provider Enumeration Date | 02/20/2014 |
| Last Update Date | 03/20/2014 |
| Medicare PECOS PAC ID | 7810120235 |
|---|---|
| Medicare Enrollment ID | O20140508001412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477978930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4101093161 (Michigan) | Primary |
| Provider Name | Mohamad Said Rahbar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679567762 PECOS PAC ID: 2466414800 Enrollment ID: I20041028000805 |
| Provider Name | Suham Dara Salman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326360504 PECOS PAC ID: 8123153103 Enrollment ID: I20100316000461 |
| Provider Name | Tesfamariam O Metiku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427289339 PECOS PAC ID: 5092981936 Enrollment ID: I20111227000651 |
| Provider Name | Hiro Rahbar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093151540 PECOS PAC ID: 1759685894 Enrollment ID: I20161026001220 |
| Provider Name | Stacy L Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780226613 PECOS PAC ID: 7911321518 Enrollment ID: I20201028002946 |
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