Independence Medical PLLC
Internal Medicine in Garden City, MI. Organization (NPI-2).
NPI number1124667316
StatusActive
Last updated in NPPESJan 5, 2020
Details
- NPI
- 1124667316
- Entity type
- Organization (NPI-2)
- Legal business name
- Independence Medical PLLC
- Organization subpart
- No
- Enumeration date
- Jan 5, 2020
- Certification date
- Jan 5, 2020
- Last updated
- Jan 5, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Other names
- Independence Medical PLLC (Doing Business As)
Practice location
6255 Inkster Rd Ste 101Garden City, MI 48135-2538
Phone 248-962-8471 · Fax 248-658-8777
Mailing address
4016 Parkwood CtBloomfield Hills, MI 48301-3967
Phone 248-962-8471
Authorized official
Ron Kattoo
Sole Owner
2489628471
Is something wrong?
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