| Metro Medical Center PLLC | |
|
11828 Joseph Campau St Hamtramck MI 48212-3049 | |
| (313) 707-0122 | |
| Not Available |
| Full Name | Metro Medical Center PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 11828 Joseph Campau St, Hamtramck, Michigan |
| Authorized Official Name and Position | Maya R Rahman (PRESIDENT) |
| Authorized Official Contact | 3137070122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metro Medical Center PLLC 11828 Joseph Campau St Hamtramck MI 48212-3049 Ph: (313) 707-0122 | Metro Medical Center PLLC 11828 Joseph Campau St Hamtramck MI 48212-3049 Ph: (313) 707-0122 |
| NPI Number | 1083359913 |
|---|---|
| Provider Enumeration Date | 05/04/2022 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 3870971815 |
|---|---|
| Medicare Enrollment ID | O20220603001794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083359913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Jesse a Castillano |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1982867420 PECOS PAC ID: 6901177286 Enrollment ID: I20170804000428 |
| Provider Name | Alexandrina Berghian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609384569 PECOS PAC ID: 2769747658 Enrollment ID: I20180524000159 |
| Provider Name | Mohammed L Rahman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720689193 PECOS PAC ID: 7517186216 Enrollment ID: I20210309000240 |
| Provider Name | Ashraf Khouchen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780468710 PECOS PAC ID: 3870941792 Enrollment ID: I20231201002511 |
| Provider Name | Mst Jannatul M Chowdhury |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619726031 PECOS PAC ID: 7315487816 Enrollment ID: I20240911001795 |
| Provider Name | Diala Khalife |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790430361 PECOS PAC ID: 3971038936 Enrollment ID: I20241127002054 |
| Provider Name | Jotee M Uddin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104614338 PECOS PAC ID: 7618461609 Enrollment ID: I20251208002060 |
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