| Obesity Medicine & Metabolic Wellness Clinic Pllc | |
|
2851 N Cedaridge Dr Midland MI 48642-8861 | |
| (248) 721-6530 | |
| Not Available |
| Full Name | Obesity Medicine & Metabolic Wellness Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2851 N Cedaridge Dr, Midland, Michigan |
| Authorized Official Name and Position | Jacob Gorelishvili (CEO) |
| Authorized Official Contact | 2487216530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Obesity Medicine & Metabolic Wellness Clinic Pllc 2851 N Cedaridge Dr Midland MI 48642-8861 Ph: (248) 721-6530 | Obesity Medicine & Metabolic Wellness Clinic Pllc 2851 N Cedaridge Dr Midland MI 48642-8861 Ph: (248) 721-6530 |
| NPI Number | 1366180671 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/25/2022 |
| Medicare PECOS PAC ID | 6002295722 |
|---|---|
| Medicare Enrollment ID | O20220627000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366180671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Teona Maghlakelidze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508078023 PECOS PAC ID: 7214036169 Enrollment ID: I20070619000256 |
| Provider Name | Jennifer L Jordahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548321045 PECOS PAC ID: 2264657899 Enrollment ID: I20190325002439 |
| Provider Name | Melinda L Hawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326649617 PECOS PAC ID: 8628481231 Enrollment ID: I20201228001431 |
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