| Olive Tree Medical Clinic Pc | |
|
18181 Oakwood Blvd Suite 206 Dearborn MI 48124-5032 | |
| (313) 451-8253 | |
| (313) 451-8351 |
| Full Name | Olive Tree Medical Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 18181 Oakwood Blvd, Dearborn, Michigan |
| Authorized Official Name and Position | Sham Juratli (PRESIDENT) |
| Authorized Official Contact | 3134518253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Tree Medical Clinic Pc 18181 Oakwood Blvd Suite 206 Dearborn MI 48124-5032 Ph: (313) 451-8253 | Olive Tree Medical Clinic Pc 18181 Oakwood Blvd Suite 206 Dearborn MI 48124-5032 Ph: (313) 451-8253 |
| NPI Number | 1457660789 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 11/02/2016 |
| Medicare PECOS PAC ID | 2860672607 |
|---|---|
| Medicare Enrollment ID | O20110210000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457660789 | NPI | - | NPPES |
| Provider Name | Sham Juratli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629136064 PECOS PAC ID: 7517967698 Enrollment ID: I20101208000991 |
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