| Silver Lake Family Practice Pllc | |
|
1100 Torrey Rd Ste 400 Fenton MI 48430-3330 | |
| (810) 714-7369 | |
| (810) 714-9258 |
| Full Name | Silver Lake Family Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1100 Torrey Rd Ste 400, Fenton, Michigan |
| Authorized Official Name and Position | Donna Benford (OWNER) |
| Authorized Official Contact | 8107147369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Lake Family Practice Pllc 1100 Torrey Rd Ste 400 Fenton MI 48430-3330 Ph: (810) 714-7369 | Silver Lake Family Practice Pllc 1100 Torrey Rd Ste 400 Fenton MI 48430-3330 Ph: (810) 714-7369 |
| NPI Number | 1124208608 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 09/23/2025 |
| Medicare PECOS PAC ID | 5890740724 |
|---|---|
| Medicare Enrollment ID | O20050314000906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124208608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Donna S Benford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073670154 PECOS PAC ID: 1052366986 Enrollment ID: I20050315000272 |
| Provider Name | Angela S Feltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851502785 PECOS PAC ID: 6507964624 Enrollment ID: I20070613000061 |
| Provider Name | Kelly A Gamache |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881086346 PECOS PAC ID: 0345567301 Enrollment ID: I20150401000103 |
| Provider Name | Dylan T Mooney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710335641 PECOS PAC ID: 5294023099 Enrollment ID: I20200211000837 |
| Provider Name | Alexandra Zdenek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346848215 PECOS PAC ID: 6103237763 Enrollment ID: I20201203000236 |
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