MEDICARE: PILLAY INTERNAL MEDICINE ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1003800269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILLAY INTERNAL MEDICINE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	100 N POND DR
Second Line	:	SUITE C
City	:	WALLED LAKE
State	:	MI
Zip	:	48390-3079
Country	:	US
Telephone Number	:	248-624-2222
Fax Number	:	248-926-9455

Provider Business Practice Location Address
First Line	:	100 N POND DR
Second Line	:	SUITE C
City	:	WALLED LAKE
State	:	MI
Zip	:	48390-3079
Country	:	US
Telephone Number	:	248-624-2222
Fax Number	:	248-926-9455

Authorized Official
Title or Position	:	OWNER
Name	:	JEET PILLAY
Credential	:	MD
Telephone Number	:	248-624-2222

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	06/26/2008

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