| Promed Preferred Mi 2, Pllc | |
|
26090 Lannys Rd Novi MI 48375-1022 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed Preferred Mi 2, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 26090 Lannys Rd, Novi, Michigan |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred Mi 2, Pllc 329 S Oyster Bay Rd # 2059 Plainview NY 11803-3301 Ph: (615) 499-3165 | Promed Preferred Mi 2, Pllc 26090 Lannys Rd Novi MI 48375-1022 Ph: (615) 499-3165 |
| NPI Number | 1245049311 |
|---|---|
| Provider Enumeration Date | 01/03/2025 |
| Last Update Date | 04/14/2025 |
| Medicare PECOS PAC ID | 0345779369 |
|---|---|
| Medicare Enrollment ID | O20250121001741 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245049311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Muhammad A Rais |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760640940 PECOS PAC ID: 3678630373 Enrollment ID: I20090325000148 |
| Provider Name | Amy K Dziurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831112085 PECOS PAC ID: 8729384219 Enrollment ID: I20160309001508 |
| Provider Name | Courtney Kiseda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982224465 PECOS PAC ID: 3072936574 Enrollment ID: I20200630002409 |
| Provider Name | Sean Arora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841729449 PECOS PAC ID: 6305184342 Enrollment ID: I20220211000142 |
| Provider Name | Lev Grinman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457511743 PECOS PAC ID: 7810011723 Enrollment ID: I20250121002080 |
| Provider Name | Kristina Mckibbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609692151 PECOS PAC ID: 7618498866 Enrollment ID: I20250305000669 |
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