| Riyadh P. Kasmikha, M.d., P.c. | |
|
28500 Southfield Rd Suite 200 Lathrup Village MI 48076-2722 | |
| (248) 440-2185 | |
| (248) 440-2189 |
| Full Name | Riyadh P. Kasmikha, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 28500 Southfield Rd, Lathrup Village, Michigan |
| Authorized Official Name and Position | Riyadh P Kasmikha (OWNER/PRESIDENT) |
| Authorized Official Contact | 2484402185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riyadh P. Kasmikha, M.d., P.c. 28500 Southfield Rd Suite 200 Lathrup Village MI 48076-2722 Ph: (248) 440-2185 | Riyadh P. Kasmikha, M.d., P.c. 28500 Southfield Rd Suite 200 Lathrup Village MI 48076-2722 Ph: (248) 440-2185 |
| NPI Number | 1174779938 |
|---|---|
| Provider Enumeration Date | 08/13/2008 |
| Last Update Date | 08/13/2008 |
| Medicare PECOS PAC ID | 4284773441 |
|---|---|
| Medicare Enrollment ID | O20091201000176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174779938 | NPI | - | NPPES |
| 4498383 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301072937 (Michigan) | Primary |
| Provider Name | Riyadh P Kasmikha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013980531 PECOS PAC ID: 0143214320 Enrollment ID: I20040412000565 |
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