| Lake Huron Medical Group | |
|
4190 24th Ave Suite 206 Fort Gratiot MI 48059-3882 | |
| (810) 216-4000 | |
| (810) 216-4001 |
| Full Name | Lake Huron Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 4190 24th Ave, Fort Gratiot, Michigan |
| Authorized Official Name and Position | Julie Ann Brown-mccoy (CBO MANAGER) |
| Authorized Official Contact | 8102162902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Huron Medical Group Po Box 638928 Cincinnati OH 45263-0669 Ph: (810) 216-1884 | Lake Huron Medical Group 4190 24th Ave Suite 206 Fort Gratiot MI 48059-3882 Ph: (810) 216-4000 |
| NPI Number | 1598141640 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 03/16/2021 |
| Medicare PECOS PAC ID | 0840507802 |
|---|---|
| Medicare Enrollment ID | O20150923002611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598141640 | NPI | - | NPPES |
| Provider Name | Patrick A Kut |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063496123 PECOS PAC ID: 4385547355 Enrollment ID: I20040128000527 |
| Provider Name | Rubina Karim |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427030329 PECOS PAC ID: 3678525219 Enrollment ID: I20050211000441 |
| Provider Name | David Bailey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235126954 PECOS PAC ID: 0244254506 Enrollment ID: I20060125000702 |
| Provider Name | Dawn Elaine Morey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003925033 PECOS PAC ID: 2062428485 Enrollment ID: I20060222000585 |
| Provider Name | Mohamed El-fakharany |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1225242449 PECOS PAC ID: 3577663616 Enrollment ID: I20070829000174 |
| Provider Name | Avinash L Jadhav |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447211545 PECOS PAC ID: 7315931573 Enrollment ID: I20080225000275 |
| Provider Name | Kristin Marie Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801029418 PECOS PAC ID: 7214072529 Enrollment ID: I20100310000808 |
| Provider Name | Jojean Hamilton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1699873612 PECOS PAC ID: 1951309798 Enrollment ID: I20110420000807 |
| Provider Name | Robert John Sachs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033203591 PECOS PAC ID: 8325108046 Enrollment ID: I20140131001768 |
| Provider Name | Margaret M Marth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740686534 PECOS PAC ID: 0840513974 Enrollment ID: I20141222002218 |
| Provider Name | Christine S Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902186752 PECOS PAC ID: 4183869886 Enrollment ID: I20150423000167 |
| Provider Name | Mohammad L Othman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841678240 PECOS PAC ID: 7012238637 Enrollment ID: I20150609000182 |
| Provider Name | Rashim Kumari Gupta |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1740424001 PECOS PAC ID: 3375776784 Enrollment ID: I20150721002266 |
| Provider Name | Shilpin A Mehta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871856948 PECOS PAC ID: 2668761727 Enrollment ID: I20170821002140 |
| Provider Name | Gaurav Bhalla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457616120 PECOS PAC ID: 0244505170 Enrollment ID: I20171003006805 |
| Provider Name | Aaron J Overly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861758880 PECOS PAC ID: 9133350549 Enrollment ID: I20171023001354 |
| Provider Name | Kristin L Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972042521 PECOS PAC ID: 5294010203 Enrollment ID: I20180907000983 |
| Provider Name | Lindsey Deborah Rieck |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194089938 PECOS PAC ID: 5395987424 Enrollment ID: I20191115000197 |
| Provider Name | Emily Grout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265058390 PECOS PAC ID: 3072931393 Enrollment ID: I20200917001450 |
| Provider Name | Alissa M Walker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922486166 PECOS PAC ID: 5597035923 Enrollment ID: I20201023002648 |
| Provider Name | Sharanya Golagabathula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326536202 PECOS PAC ID: 6406105113 Enrollment ID: I20210728002533 |
| Provider Name | Emily Jean Puzan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891351672 PECOS PAC ID: 5799178588 Enrollment ID: I20220128002173 |
| Provider Name | Shivashankar Damodaran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528558277 PECOS PAC ID: 2264781186 Enrollment ID: I20230919003815 |
B. Nakhleh, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059 Phone: 810-216-4000 Fax: 810-216-4001 | |
Randy J. Plonka M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5979 Lakeshore Rd, Fort Gratiot, MI 48059 Phone: 810-385-6370 Fax: 810-385-6357 | |
Lighthouse Family Medicine, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4071 24th Ave, Fort Gratiot, MI 48059 Phone: 810-824-4222 Fax: 810-824-4220 | |
Horizon Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3041 Commerce Dr Ste B, Fort Gratiot, MI 48059 Phone: 810-385-4342 | |
Port Huron Mercy Family Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059 Phone: 810-216-4000 Fax: 810-216-4001 | |
Sunrise Pace Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5229 Lakeshore Road, Fort Gratiot, MI 48059 Phone: 810-388-6300 Fax: 810-388-6305 |