| Great Health Medical Mi Pc | |
|
3011 N Center Rd Flint MI 48506-3149 | |
| (718) 470-0288 | |
| Not Available |
| Full Name | Great Health Medical Mi Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3011 N Center Rd, Flint, Michigan |
| Authorized Official Name and Position | Azlan Tariq (OWNER) |
| Authorized Official Contact | 3127097238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Health Medical Mi Pc 407 Willoughby Ave Brooklyn NY 11205-4590 Ph: () - | Great Health Medical Mi Pc 3011 N Center Rd Flint MI 48506-3149 Ph: (718) 470-0288 |
| NPI Number | 1336958792 |
|---|---|
| Provider Enumeration Date | 12/31/2024 |
| Last Update Date | 01/22/2025 |
| Medicare PECOS PAC ID | 8628508355 |
|---|---|
| Medicare Enrollment ID | O20250211002849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336958792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Roslyn D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033526363 PECOS PAC ID: 5395962104 Enrollment ID: I20140818002255 |
| Provider Name | Joy Marie Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417531757 PECOS PAC ID: 7719377100 Enrollment ID: I20211129000323 |
| Provider Name | Azlan Tariq |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1528291283 PECOS PAC ID: 1355504267 Enrollment ID: I20220614000276 |
| Provider Name | Jessie Page Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467169748 PECOS PAC ID: 4587036603 Enrollment ID: I20230217001036 |
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