| St. Charles Family Clinic Pllc | |
| 
					611 W Belle Avenue Saint Charles MI 48655  | |
| (989) 865-9958 | |
| (989) 865-8099 | 
| Full Name | St. Charles Family Clinic Pllc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 611 W Belle Avenue, Saint Charles, Michigan | 
| Authorized Official Name and Position | Naveed Mahfooz (OWNER) | 
| Authorized Official Contact | 9898659958 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| St. Charles Family Clinic Pllc 611 W Belle Ave Saint Charles MI 48655-1611 Ph: (989) 865-9958  | St. Charles Family Clinic Pllc 611 W Belle Avenue Saint Charles MI 48655 Ph: (989) 865-9958  | 
| NPI Number | 1669837993 | 
|---|---|
| Provider Enumeration Date | 12/31/2015 | 
| Last Update Date | 02/07/2019 | 
| Medicare PECOS PAC ID | 8527358035 | 
|---|---|
| Medicare Enrollment ID | O20160610001414 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669837993 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301059644 (Michigan) | Primary | 
| Provider Name | Naveed Mahfooz | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1780639450 PECOS PAC ID: 9830158609 Enrollment ID: I20050606000749  | 
| Provider Name | Theresa I Jensen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639569916 PECOS PAC ID: 5496075939 Enrollment ID: I20150522001359  | 
| Provider Name | Jillian S Rodney | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205295573 PECOS PAC ID: 9133427172 Enrollment ID: I20160407001444  | 
| Provider Name | Jonathan W Hollis | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205298262 PECOS PAC ID: 7719285378 Enrollment ID: I20160414000968  | 
| Provider Name | Chad Wolinski | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1760847883 PECOS PAC ID: 8729373352 Enrollment ID: I20160822002509  | 
| Provider Name | Courtney Lynn Atkinson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1164990669 PECOS PAC ID: 1658616636 Enrollment ID: I20181219001483  | 
| Provider Name | Rabeea Mirza | 
|---|---|
| Provider Type | Practitioner - Rheumatology | 
| Provider Identifiers | NPI Number: 1679993216 PECOS PAC ID: 3577866649 Enrollment ID: I20190531000026  | 
| Provider Name | Kimberly Truckner | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538635842 PECOS PAC ID: 7911231485 Enrollment ID: I20190703001078  | 
| Provider Name | Cynthia C Evans | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1881238517 PECOS PAC ID: 4284049834 Enrollment ID: I20210212001958  | 
Ronald L Gonzales Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1124 N Saginaw St, Saint Charles, MI 48655 Phone: 989-865-8270 Fax: 989-865-8582  |