| Vip Home Physicians PLLC | |
|
17425 Mack Ave Detroit MI 48224-1437 | |
| (313) 499-8991 | |
| (313) 499-8938 |
| Full Name | Vip Home Physicians PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 17425 Mack Ave, Detroit, Michigan |
| Authorized Official Name and Position | Stephen J Palajac (PRESIDENT) |
| Authorized Official Contact | 3136006328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Home Physicians PLLC 17425 Mack Ave Detroit MI 48224-1437 Ph: (313) 499-8991 | Vip Home Physicians PLLC 17425 Mack Ave Detroit MI 48224-1437 Ph: (313) 499-8991 |
| NPI Number | 1689496820 |
|---|---|
| Provider Enumeration Date | 10/29/2024 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 7416483813 |
|---|---|
| Medicare Enrollment ID | O20241209003268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689496820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 213E00000X | Podiatrist | () | Secondary |
| Provider Name | Andrew J Borin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346212800 PECOS PAC ID: 1052390267 Enrollment ID: I20040720000168 |
| Provider Name | Stanislaus J Orowe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144370479 PECOS PAC ID: 8022080985 Enrollment ID: I20040811000155 |
| Provider Name | Dwight Encinas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1942378757 PECOS PAC ID: 9436160140 Enrollment ID: I20060509000884 |
| Provider Name | Stephen James Palajac |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821025602 PECOS PAC ID: 7517937386 Enrollment ID: I20070714000185 |
| Provider Name | Scott a Graves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023169026 PECOS PAC ID: 7911032602 Enrollment ID: I20100319000552 |
| Provider Name | Patrick Kerr |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891757050 PECOS PAC ID: 9032391966 Enrollment ID: I20110314000398 |
| Provider Name | Fatoumata Moukir Ndukwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902398787 PECOS PAC ID: 8921332842 Enrollment ID: I20190627000085 |
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