| Renal Associates Of Mid-michigan Pc | |
|
415 W Wackerly St Midland MI 48640-2761 | |
| (989) 837-6505 | |
| (989) 835-8428 |
| Full Name | Renal Associates Of Mid-michigan Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 415 W Wackerly St, Midland, Michigan |
| Authorized Official Name and Position | Adeel Khan (PRESIDENT) |
| Authorized Official Contact | 9898376505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renal Associates Of Mid-michigan Pc 415 W Wackerly St Midland MI 48640-2761 Ph: (989) 837-6505 | Renal Associates Of Mid-michigan Pc 415 W Wackerly St Midland MI 48640-2761 Ph: (989) 837-6505 |
| NPI Number | 1194911941 |
|---|---|
| Provider Enumeration Date | 09/14/2007 |
| Last Update Date | 07/22/2008 |
| Medicare PECOS PAC ID | 3072684638 |
|---|---|
| Medicare Enrollment ID | O20080625000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194911941 | NPI | - | NPPES |
| 0E61173 | Other | MI | BCBSM |
| Provider Name | Adeel Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1467481465 PECOS PAC ID: 7012802283 Enrollment ID: I20040217000564 |
| Provider Name | David B Butcher |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164469862 PECOS PAC ID: 6507878089 Enrollment ID: I20060627000276 |
| Provider Name | Cindy R Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619112281 PECOS PAC ID: 1254498314 Enrollment ID: I20090318000116 |
| Provider Name | Julie A Reneaud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942575907 PECOS PAC ID: 0244490589 Enrollment ID: I20120324000033 |
| Provider Name | Kenda J Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093073025 PECOS PAC ID: 0042461592 Enrollment ID: I20121110000228 |
| Provider Name | Syed Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992903157 PECOS PAC ID: 0840434106 Enrollment ID: I20130926000605 |
| Provider Name | Jenna M Mccummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972073807 PECOS PAC ID: 5496092033 Enrollment ID: I20190121001187 |
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