| Meadowbrook Primary Care, Pllc | |
|
2050 N Haggerty Rd Ste 260 Canton MI 48187-3796 | |
| (734) 892-2712 | |
| (734) 892-2714 |
| Full Name | Meadowbrook Primary Care, Pllc |
|---|---|
| Speciality | Nursing Care |
| Location | 2050 N Haggerty Rd Ste 260, Canton, Michigan |
| Authorized Official Name and Position | Sarju Shah (OWNER / PRESIDENT) |
| Authorized Official Contact | 7348922712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadowbrook Primary Care, Pllc 2050 N Haggerty Rd Ste 260 Canton MI 48187-3796 Ph: (734) 892-2712 | Meadowbrook Primary Care, Pllc 2050 N Haggerty Rd Ste 260 Canton MI 48187-3796 Ph: (734) 892-2712 |
| NPI Number | 1154712073 |
|---|---|
| Provider Enumeration Date | 02/13/2015 |
| Last Update Date | 04/18/2019 |
| Medicare PECOS PAC ID | 2769700160 |
|---|---|
| Medicare Enrollment ID | O20150415001212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154712073 | NPI | - | NPPES |
| Provider Name | Falgun C Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932319415 PECOS PAC ID: 5890862056 Enrollment ID: I20080930000472 |
| Provider Name | James Tisius |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609122084 PECOS PAC ID: 2466743265 Enrollment ID: I20160627000963 |
| Provider Name | Russell A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013455922 PECOS PAC ID: 1759665292 Enrollment ID: I20170301002297 |
| Provider Name | Jamie Fineran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366953473 PECOS PAC ID: 9133485378 Enrollment ID: I20171103002569 |
| Provider Name | Heidi H Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417483678 PECOS PAC ID: 0749530244 Enrollment ID: I20180904002436 |
| Provider Name | Salman Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043690183 PECOS PAC ID: 0446559066 Enrollment ID: I20190604001729 |
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