| Laz Medical Group Pc | |
|
20755 Greenfield Rd #1101 Southfield MI 48075-5403 | |
| (248) 569-7550 | |
| (313) 561-0277 |
| Full Name | Laz Medical Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 20755 Greenfield Rd, Southfield, Michigan |
| Authorized Official Name and Position | Zakari Tata (PHYSICIAN OWNER) |
| Authorized Official Contact | 2485697550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laz Medical Group Pc Po Box 250005 W Bloomfield MI 48325-0005 Ph: (248) 569-7550 | Laz Medical Group Pc 20755 Greenfield Rd #1101 Southfield MI 48075-5403 Ph: (248) 569-7550 |
| NPI Number | 1053310128 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 7810887288 |
|---|---|
| Medicare Enrollment ID | O20040318000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053310128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QH0002X | Family Medicine - Hospice And Palliative Medicine | (* (Not Available)) | Secondary |
| Provider Name | Zakari M Tata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871591313 PECOS PAC ID: 9436049806 Enrollment ID: I20040318001713 |
| Provider Name | Ralph J Tidalgo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427168525 PECOS PAC ID: 3274513478 Enrollment ID: I20040722000488 |
| Provider Name | Carmen L Cardona |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851519433 PECOS PAC ID: 4688689946 Enrollment ID: I20060208000497 |
| Provider Name | James A Carthron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760693196 PECOS PAC ID: 5597851550 Enrollment ID: I20071022000781 |
| Provider Name | Alice N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558615419 PECOS PAC ID: 0345494738 Enrollment ID: I20130213000036 |
| Provider Name | Chinwe Prisca Ohaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700226875 PECOS PAC ID: 9436453685 Enrollment ID: I20160208001937 |
| Provider Name | Yolanda Y Cuff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215385851 PECOS PAC ID: 6406140615 Enrollment ID: I20160811000581 |
| Provider Name | Charlene Walton Windham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518336080 PECOS PAC ID: 7416235965 Enrollment ID: I20161103001248 |
| Provider Name | Dequindra Blakey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417303355 PECOS PAC ID: 3173807419 Enrollment ID: I20170303001827 |
| Provider Name | Ogechi Nita Enyioko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285191254 PECOS PAC ID: 9739428632 Enrollment ID: I20190311001052 |
| Provider Name | Candace Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962984823 PECOS PAC ID: 6406159383 Enrollment ID: I20200508001034 |
| Provider Name | Awah L Ditah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851982557 PECOS PAC ID: 1850799040 Enrollment ID: I20211001000433 |
| Provider Name | Amie Sankareh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659992519 PECOS PAC ID: 2769873140 Enrollment ID: I20211217002132 |
| Provider Name | Anisha A Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275007544 PECOS PAC ID: 4880061241 Enrollment ID: I20221028000322 |
| Provider Name | Mojisola Adeboye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356045280 PECOS PAC ID: 5698133916 Enrollment ID: I20230620000541 |
Med-share, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26222 Telegraph Rd, Suite 100, Southfield, MI 48033 Phone: 248-827-7200 Fax: 248-827-2641 | |
Caring Doctors At Home Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29600 Northwestern Highway, Suite 106, Southfield, MI 48034 Phone: 313-258-4855 | |
Maecenas Health Systems Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26677 W 12 Mile Rd, Southfield, MI 48034 Phone: 248-358-6995 | |
Ark Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23999 Northwestern Hwy, Southfield, MI 48075 Phone: 248-924-1429 Fax: 248-419-2431 | |
Laina Feinstein Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 29829 Telegraph Rd, Suite 107, Southfield, MI 48034 Phone: 248-304-0786 Fax: 248-354-8559 | |
Magnum Managment Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17600 W 8 Mile Rd, Suite # 5, Southfield, MI 48075 Phone: 248-424-9749 | |
American Current Care Of Michigan, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26185 Greenfield Rd, Southfield, MI 48076 Phone: 248-569-2040 Fax: 248-569-2048 |