| Opdyke Medical, Pllc | |
|
3959 Centerpoint Pkwy Ste 100 Pontiac MI 48341-3121 | |
| (248) 333-2600 | |
| (248) 333-3250 |
| Full Name | Opdyke Medical, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3959 Centerpoint Pkwy Ste 100, Pontiac, Michigan |
| Authorized Official Name and Position | Marie Therese Crum (ADMINISTRATOR) |
| Authorized Official Contact | 2482405699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opdyke Medical, Pllc 3959 Centerpoint Pkwy Ste 100 Pontiac MI 48341-3121 Ph: (248) 333-2600 | Opdyke Medical, Pllc 3959 Centerpoint Pkwy Ste 100 Pontiac MI 48341-3121 Ph: (248) 333-2600 |
| NPI Number | 1154664688 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 04/13/2023 |
| Medicare PECOS PAC ID | 0941441695 |
|---|---|
| Medicare Enrollment ID | O20130723000926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154664688 | NPI | - | NPPES |
| 2805350 | Medicaid | MI |
| Provider Name | Nada Beydoun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912293978 PECOS PAC ID: 1658598057 Enrollment ID: I20140807002678 |
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