| 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 |