| Southeast Internal Medicine Pllc | |
|
29159 Helman Blvd Brownstown MI 48183 | |
| (734) 671-5100 | |
| (734) 671-7664 |
| Full Name | Southeast Internal Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 29159 Helman Blvd, Brownstown, Michigan |
| Authorized Official Name and Position | Margaret Mcquiston (OWNER PHYSICIAN) |
| Authorized Official Contact | 7346715100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Internal Medicine Pllc 29159 Helman Brownstown MI 48183-0172 Ph: (734) 671-5100 | Southeast Internal Medicine Pllc 29159 Helman Blvd Brownstown MI 48183 Ph: (734) 671-5100 |
| NPI Number | 1326046418 |
|---|---|
| Provider Enumeration Date | 07/12/2005 |
| Last Update Date | 10/16/2007 |
| Medicare PECOS PAC ID | 0345299319 |
|---|---|
| Medicare Enrollment ID | O20050117000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326046418 | NPI | - | NPPES |
| 4323064 | Medicaid | MI | |
| 4439990 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5101012342 (Michigan) | Primary |
| Provider Name | Judy Ann Sorovetz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235137803 PECOS PAC ID: 1355390329 Enrollment ID: I20050117000356 |
| Provider Name | Margaret Ann Mcquiston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487652004 PECOS PAC ID: 2062461031 Enrollment ID: I20101117000758 |