| Keri Heart Medical Center | |
|
18600 James Couzens Fwy Detroit MI 48235-2509 | |
| (248) 843-5470 | |
| (313) 758-6429 |
| Full Name | Keri Heart Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 18600 James Couzens Fwy, Detroit, Michigan |
| Authorized Official Name and Position | Makula Brown (PROVIDER) |
| Authorized Official Contact | 3137586429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keri Heart Medical Center 18600 James Couzens Fwy Detroit MI 48235-2509 Ph: (313) 758-6429 | Keri Heart Medical Center 18600 James Couzens Fwy Detroit MI 48235-2509 Ph: (248) 843-5470 |
| NPI Number | 1871281121 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 11/13/2025 |
| Certification Date | 11/13/2025 |
| Medicare PECOS PAC ID | 8527587088 |
|---|---|
| Medicare Enrollment ID | O20250528001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871281121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
| Provider Name | Laquanda P Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043334055 PECOS PAC ID: 4385874551 Enrollment ID: I20140310000123 |
| Provider Name | Angelique Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477876019 PECOS PAC ID: 2365704814 Enrollment ID: I20180320003272 |
| Provider Name | Makula Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942813712 PECOS PAC ID: 0941586457 Enrollment ID: I20201125001965 |
| Provider Name | Juliet Gaisey |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316332711 PECOS PAC ID: 8820346554 Enrollment ID: I20221212000924 |
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