| Real Estate 4000 Llc | |
| 
					19130 Sumpter Rd Sumpter Twp MI 48111-8724  | |
| (313) 485-1411 | |
| Not Available | 
| Full Name | Real Estate 4000 Llc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 19130 Sumpter Rd, Sumpter Twp, Michigan | 
| Authorized Official Name and Position | Valerie Makhool (CREDENTIALING) | 
| Authorized Official Contact | 3133775331 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Real Estate 4000 Llc 27055 Northmore St Dearborn Heights MI 48127-3643 Ph: (313) 377-5331  | Real Estate 4000 Llc 19130 Sumpter Rd Sumpter Twp MI 48111-8724 Ph: (313) 485-1411  | 
| NPI Number | 1619463023 | 
|---|---|
| Provider Enumeration Date | 07/09/2018 | 
| Last Update Date | 07/09/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1619463023 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |