| Light Of Hope Family Medical Clinic | |
|
9600 Dexter Ave Detroit MI 48206-1816 | |
| (313) 894-7881 | |
| (313) 894-6312 |
| Full Name | Light Of Hope Family Medical Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 9600 Dexter Ave, Detroit, Michigan |
| Authorized Official Name and Position | Karl Bandlien (PRESIDENT) |
| Authorized Official Contact | 3138947881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light Of Hope Family Medical Clinic 9600 Dexter Ave Detroit MI 48206-1816 Ph: (313) 894-7881 | Light Of Hope Family Medical Clinic 9600 Dexter Ave Detroit MI 48206-1816 Ph: (313) 894-7881 |
| NPI Number | 1497172381 |
|---|---|
| Provider Enumeration Date | 03/28/2014 |
| Last Update Date | 03/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497172381 | NPI | - | NPPES |
| 0820397 | Other | MI | BCBS OF MICHIGAN |
| 4754287 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 4301046832 (Michigan) | Primary |
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