| Vinod Kohli Md Pc | |
|
25511 Van Dyke Avenue Suite 200 Center Line MI 48015-1834 | |
| (586) 759-6300 | |
| (586) 759-1409 |
| Full Name | Vinod Kohli Md Pc |
|---|---|
| Speciality | General Practice |
| Location | 25511 Van Dyke Avenue, Center Line, Michigan |
| Authorized Official Name and Position | Vinod Kohli (PRESIDENT) |
| Authorized Official Contact | 5865302197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vinod Kohli Md Pc 25511 Van Dyke Avenue Suite 200 Center Line MI 48015-1834 Ph: (586) 759-6300 | Vinod Kohli Md Pc 25511 Van Dyke Avenue Suite 200 Center Line MI 48015-1834 Ph: (586) 759-6300 |
| NPI Number | 1760636971 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 07/17/2024 |
| Medicare PECOS PAC ID | 1355471632 |
|---|---|
| Medicare Enrollment ID | O20100612000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760636971 | NPI | - | NPPES |
| 0105005271 | Other | MI | BCBS |
| MI335057710 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301040989 (Michigan) | Primary |
| Provider Name | Vinod K Kohli |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770681470 PECOS PAC ID: 5991793382 Enrollment ID: I20040504001165 |
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