| Michigan Gastroenterology Pllc | |
|
29000 Little Mack Ave Ste A Saint Clair Shores MI 48081-3018 | |
| (313) 644-0040 | |
| Not Available |
| Full Name | Michigan Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 29000 Little Mack Ave Ste A, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Robbie Taha (OWNER) |
| Authorized Official Contact | 3136440040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Gastroenterology Pllc 29000 Little Mack Ave Ste A Saint Clair Shores MI 48081-3018 Ph: (313) 644-0040 | Michigan Gastroenterology Pllc 29000 Little Mack Ave Ste A Saint Clair Shores MI 48081-3018 Ph: (313) 644-0040 |
| NPI Number | 1730911694 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 11/12/2024 |
| Medicare PECOS PAC ID | 1951838911 |
|---|---|
| Medicare Enrollment ID | O20250102002811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730911694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Robbie H Taha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235251042 PECOS PAC ID: 7810020443 Enrollment ID: I20190906002931 |
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