| Maridel Hernandez Internal Medicine Pc | |
|
131 Kercheval Ave Suite 120 Grosse Pointe Farms MI 48236-3629 | |
| (313) 640-8400 | |
| (313) 640-9232 |
| Full Name | Maridel Hernandez Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 131 Kercheval Ave, Grosse Pointe Farms, Michigan |
| Authorized Official Name and Position | Maridel Hernandez (OWNER CEO) |
| Authorized Official Contact | 3136408400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maridel Hernandez Internal Medicine Pc 131 Kercheval Ave Suite 120 Grosse Pointe Farms MI 48236-3629 Ph: (313) 640-8400 | Maridel Hernandez Internal Medicine Pc 131 Kercheval Ave Suite 120 Grosse Pointe Farms MI 48236-3629 Ph: (313) 640-8400 |
| NPI Number | 1366526378 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 01/12/2011 |
| Medicare PECOS PAC ID | 0143244475 |
|---|---|
| Medicare Enrollment ID | O20060125000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366526378 | NPI | - | NPPES |
| 0E02258 | Other | MI | BCBS PIN |
| 1158213464 | Other | MI | BLUE CROSS BLUE SHIELD |
| 4869383-11 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5101012021 (Michigan) | Primary |
| Provider Name | Maridel A Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023013711 PECOS PAC ID: 8022032366 Enrollment ID: I20060127000359 |
Grosse Pointe Comprehensive Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18348 Mack Ave, Grosse Pointe Farms, MI 48236 Phone: 313-881-7010 | |
Grosse Pointe Surgical & Medical Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18348 Mack Ave, Grosse Pointe Farms, MI 48236 Phone: 313-881-7010 | |
Ronald F. Williamson M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18348 Mack Ave, Grosse Pointe Farms, MI 48236 Phone: 313-862-3104 Fax: 313-862-1290 |