| Radiancemd | |
|
8552 N Canton Center Rd Canton MI 48187-1310 | |
| (248) 910-4123 | |
| (888) 378-0244 |
| Full Name | Radiancemd |
|---|---|
| Speciality | Family Medicine |
| Location | 8552 N Canton Center Rd, Canton, Michigan |
| Authorized Official Name and Position | Nayantara Jnananand (OWNER) |
| Authorized Official Contact | 2489104123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiancemd 8552 N Canton Center Rd Canton MI 48187-1310 Ph: (248) 910-4123 | Radiancemd 8552 N Canton Center Rd Canton MI 48187-1310 Ph: (248) 910-4123 |
| NPI Number | 1831764273 |
|---|---|
| Provider Enumeration Date | 05/26/2021 |
| Last Update Date | 05/26/2021 |
| Certification Date | 05/26/2021 |
| Medicare PECOS PAC ID | 1850775107 |
|---|---|
| Medicare Enrollment ID | O20220906000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831764273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Nayantara a Jnananand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013128925 PECOS PAC ID: 0648316521 Enrollment ID: I20110506000274 |
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