| Avenue Health | |
|
2422 Jolly Rd Ste 100 Okemos MI 48864-3690 | |
| (517) 618-9507 | |
| Not Available |
| Full Name | Avenue Health |
|---|---|
| Speciality | Family Medicine |
| Location | 2422 Jolly Rd Ste 100, Okemos, Michigan |
| Authorized Official Name and Position | Michelle Gormas (MANAGER) |
| Authorized Official Contact | 5176189507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenue Health 2422 Jolly Rd Ste 100 Okemos MI 48864-3690 Ph: (517) 618-9507 | Avenue Health 2422 Jolly Rd Ste 100 Okemos MI 48864-3690 Ph: (517) 618-9507 |
| NPI Number | 1124631445 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 09/17/2021 |
| Medicare PECOS PAC ID | 9335550375 |
|---|---|
| Medicare Enrollment ID | O20201124001683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124631445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Melody A Angel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770662025 PECOS PAC ID: 8729184403 Enrollment ID: I20070427000051 |
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