| My Family Doctor | |
|
12100 Dix Toledo Rd Southgate MI 48195-3531 | |
| (734) 282-5502 | |
| (734) 282-7106 |
| Full Name | My Family Doctor |
|---|---|
| Speciality | Clinic/Center |
| Location | 12100 Dix Toledo Rd, Southgate, Michigan |
| Authorized Official Name and Position | Harshavardhan R Krishna (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3138911500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Family Doctor 12100 Dix Toledo Rd Southgate MI 48195-3531 Ph: (734) 282-5502 | My Family Doctor 12100 Dix Toledo Rd Southgate MI 48195-3531 Ph: (734) 282-5502 |
| NPI Number | 1629001235 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 03/30/2022 |
| Medicare PECOS PAC ID | 7517994999 |
|---|---|
| Medicare Enrollment ID | O20050719000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629001235 | NPI | - | NPPES |
| 10-4942723 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | 4301070833 (Michigan) | Primary |
| Provider Name | Harshavardhan R Krishna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154354769 PECOS PAC ID: 2668431164 Enrollment ID: I20041008001367 |
| Provider Name | Prem Raj |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386854792 PECOS PAC ID: 6709823107 Enrollment ID: I20050415000658 |
| Provider Name | Sudha Reddy |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1922023340 PECOS PAC ID: 1355365859 Enrollment ID: I20070322000110 |
| Provider Name | Michael L Gambel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770585580 PECOS PAC ID: 8426184318 Enrollment ID: I20100330001040 |
| Provider Name | Lisa R Dugas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235437831 PECOS PAC ID: 5193908143 Enrollment ID: I20110329000227 |
| Provider Name | Kevin S Kendzierski |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1629053681 PECOS PAC ID: 9739142837 Enrollment ID: I20200810002297 |
A.m. Mussani, Md., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12815 Northline Rd, Southgate, MI 48195 Phone: 734-284-2090 Fax: 734-284-9666 | |
Yassir Attalla Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15450 Northline Rd Ste 102, Southgate, MI 48195 Phone: 734-282-2020 Fax: 734-282-2002 | |
Uzma Zafar Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3 Heritage Dr Ste 1, Southgate, MI 48195 Phone: 734-283-3222 | |
Southfort Family Clinic Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13650 Fort St, Southgate, MI 48195 Phone: 734-281-2150 | |
Bedside Specialists Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12100 Dix Toledo Rd, Southgate, MI 48195 Phone: 734-282-5502 | |
Megha Mohey Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14752 Northline Rd, Southgate, MI 48195 Phone: 734-785-6003 Fax: 734-985-2333 | |
Priority 1 Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15450 Northline Rd, Southgate, MI 48195 Phone: 313-898-4390 |