| Medpro Primary Care Pllc | |
|
17901 Huron River Dr New Boston MI 48164-3200 | |
| (734) 315-7070 | |
| Not Available |
| Full Name | Medpro Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17901 Huron River Dr, New Boston, Michigan |
| Authorized Official Name and Position | Joshua Ruedisueli (OWNER) |
| Authorized Official Contact | 7343157070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medpro Primary Care Pllc 17901 Huron River Dr New Boston MI 48164-3200 Ph: (734) 315-7070 | Medpro Primary Care Pllc 17901 Huron River Dr New Boston MI 48164-3200 Ph: (734) 315-7070 |
| NPI Number | 1639700107 |
|---|---|
| Provider Enumeration Date | 02/03/2020 |
| Last Update Date | 02/11/2021 |
| Medicare PECOS PAC ID | 7416386404 |
|---|---|
| Medicare Enrollment ID | O20200326000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639700107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael G Jakubik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457753956 PECOS PAC ID: 5092030841 Enrollment ID: I20150219000507 |
| Provider Name | Daniel Md Kapadia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093179681 PECOS PAC ID: 0244575900 Enrollment ID: I20181227001704 |
| Provider Name | Matthew A Zaborowicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528596723 PECOS PAC ID: 7618248790 Enrollment ID: I20210903001485 |
| Provider Name | Samantha Demarce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447957816 PECOS PAC ID: 1355715442 Enrollment ID: I20230312000003 |
Arjan Medical Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19270 Hannan Rd, New Boston, MI 48164 Phone: 313-710-4906 Fax: 877-269-6962 | |
Vijayalakshmi Nagappan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19270 Hannan Rd, New Boston, MI 48164 Phone: 248-396-1306 | |
Toms P. Mathew M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19270 Hannan Rd, New Boston, MI 48164 Phone: 734-753-4350 |