| Ppom | |
|
19145 Allen Rd Suite # 107 Brownstown Twp MI 48183-6812 | |
| (734) 486-4200 | |
| Not Available |
| Full Name | Ppom |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 19145 Allen Rd, Brownstown Twp, Michigan |
| Authorized Official Name and Position | Kashif Qureshi (PHYSICIAN) |
| Authorized Official Contact | 7344864200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppom 19145 Allen Rd Suite # 107 Brownstown Twp MI 48183-6812 Ph: (734) 486-4200 | Ppom 19145 Allen Rd Suite # 107 Brownstown Twp MI 48183-6812 Ph: (734) 486-4200 |
| NPI Number | 1588095863 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 12/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588095863 | NPI | - | NPPES |
| 1346340379 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301096426 (Michigan) | Primary |
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