| Western Wayne Physicians, Plc | |
|
7445 Allen Rd Suite 250 Allen Park MI 48101-1963 | |
| (313) 386-5500 | |
| (313) 386-3444 |
| Full Name | Western Wayne Physicians, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 7445 Allen Rd, Allen Park, Michigan |
| Authorized Official Name and Position | Robert J Jackson (OWNER / SECRETARY) |
| Authorized Official Contact | 3133865500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Wayne Physicians, Plc 7445 Allen Rd Suite 250 Allen Park MI 48101-1963 Ph: (313) 386-5500 | Western Wayne Physicians, Plc 7445 Allen Rd Suite 250 Allen Park MI 48101-1963 Ph: (313) 386-5500 |
| NPI Number | 1629263520 |
|---|---|
| Provider Enumeration Date | 09/13/2007 |
| Last Update Date | 03/18/2008 |
| Medicare PECOS PAC ID | 8820031776 |
|---|---|
| Medicare Enrollment ID | O20050602000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629263520 | NPI | - | NPPES |
| 3506382 | Medicaid | MI | |
| 4172620 | Medicaid | MI | |
| 4545062 | Medicaid | MI | |
| 4172611 | Medicaid | MI | |
| CD8151 | Other | MI | RAILROAD MEDICARE |
| CC4542 | Other | MI | RAILROAD MEDICARE |
| 4545053 | Medicaid | MI | |
| 4281910 | Medicaid | MI | |
| 4572954 | Medicaid | MI | |
| CG3535 | Other | MI | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jane P Kramar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649242165 PECOS PAC ID: 2062496557 Enrollment ID: I20040614000914 |
| Provider Name | John T Mccracken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811960081 PECOS PAC ID: 0244273191 Enrollment ID: I20060323000585 |
| Provider Name | Donald B Welker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023081460 PECOS PAC ID: 5597708453 Enrollment ID: I20080606000638 |
| Provider Name | David W Peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457324451 PECOS PAC ID: 0042253908 Enrollment ID: I20080606000640 |
| Provider Name | David C Dziobak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215900667 PECOS PAC ID: 5698718559 Enrollment ID: I20080606000660 |
| Provider Name | Joseph C Beaman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366415705 PECOS PAC ID: 0143263004 Enrollment ID: I20080726000076 |
| Provider Name | Patricia Colleen Nester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326010828 PECOS PAC ID: 4981647831 Enrollment ID: I20100831000678 |
| Provider Name | Robert John Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891768057 PECOS PAC ID: 1456394303 Enrollment ID: I20100925000146 |
| Provider Name | Donna Lenore Angell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952373441 PECOS PAC ID: 8628011574 Enrollment ID: I20101103001430 |
| Provider Name | Daniel Carl Angell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568836385 PECOS PAC ID: 8224380969 Enrollment ID: I20181009000507 |
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