| Stoney Creek Physicians | |
|
441 S Livernois Rd Ste 185 Rochester Hills MI 48307-2585 | |
| (248) 963-2191 | |
| Not Available |
| Full Name | Stoney Creek Physicians |
|---|---|
| Speciality | Clinic/Center |
| Location | 441 S Livernois Rd Ste 185, Rochester Hills, Michigan |
| Authorized Official Name and Position | Latha Srikrishna (PRESIDENT) |
| Authorized Official Contact | 2482105404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stoney Creek Physicians 441 S Livernois Rd Ste 185 Rochester Hills MI 48307-2585 Ph: (248) 841-1040 | Stoney Creek Physicians 441 S Livernois Rd Ste 185 Rochester Hills MI 48307-2585 Ph: (248) 963-2191 |
| NPI Number | 1295205532 |
|---|---|
| Provider Enumeration Date | 11/29/2018 |
| Last Update Date | 12/08/2019 |
| Medicare PECOS PAC ID | 5193061398 |
|---|---|
| Medicare Enrollment ID | O20190109000815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295205532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Latha Srikrishna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316025695 PECOS PAC ID: 6406896695 Enrollment ID: I20050506000419 |
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