| Jerry Nosanchuk Do Pllc | |
|
31500 Telegraph Rd Suite 210 Bingham Farms MI 48025-4367 | |
| (248) 644-7200 | |
| (248) 644-7210 |
| Full Name | Jerry Nosanchuk Do Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 31500 Telegraph Rd, Bingham Farms, Michigan |
| Authorized Official Name and Position | Jerry Nosanchuk (PHYSICIAN) |
| Authorized Official Contact | 2489268080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Nosanchuk Do Pllc 4545 Northridge Ct West Bloomfield MI 48323-1397 Ph: (248) 926-8080 | Jerry Nosanchuk Do Pllc 31500 Telegraph Rd Suite 210 Bingham Farms MI 48025-4367 Ph: (248) 644-7200 |
| NPI Number | 1023281706 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Medicare PECOS PAC ID | 7911193313 |
|---|---|
| Medicare Enrollment ID | O20101124000774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023281706 | NPI | - | NPPES |
| 0158224424 | Other | MI | BCBS MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Jerry L Nosanchuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568529931 PECOS PAC ID: 9638365760 Enrollment ID: I20101201000111 |
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