| Physicians Residential Services, P.C. | |
|
20927 Kelly Rd Eastpointe MI 48021-3128 | |
| (586) 777-8801 | |
| (586) 777-9988 |
| Full Name | Physicians Residential Services, P.C. |
|---|---|
| Speciality | General Practice |
| Location | 20927 Kelly Rd, Eastpointe, Michigan |
| Authorized Official Name and Position | Edwin J Soler-valcourt (PRESIDENT) |
| Authorized Official Contact | 5867778801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Residential Services, P.C. 20927 Kelly Rd Eastpointe MI 48021-3128 Ph: (586) 777-8801 | Physicians Residential Services, P.C. 20927 Kelly Rd Eastpointe MI 48021-3128 Ph: (586) 777-8801 |
| NPI Number | 1700866811 |
|---|---|
| Provider Enumeration Date | 01/17/2006 |
| Last Update Date | 12/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700866811 | NPI | - | NPPES |
| 010E010070 | Other | BCBSM | |
| P00405274 | Other | RAILROAD MEDICARE | |
| 104784286 | Medicaid | MI | |
| 010066340 | Other | RAILROAD MEDICARE | |
| 104676117 | Medicaid | MI | |
| P00298680 | Other | RAILROAD MEDICARE | |
| 135198828 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301068676 (Michigan) | Primary |
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