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NPI Code Detail

MEDICARE: COUNTRY CREEK FAMILY PHYSICIANS

MEDICARE: COUNTRY CREEK FAMILY PHYSICIANS
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
1207R00000XInternal Medicine Physician
2363A00000XPhysician Assistant
3207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10F32698OTHERBCBS

General Provider Information

NPI Number : 1104889773
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTRY CREEK FAMILY PHYSICIANS
Provider Business Mailing Address
First Line : 4986 ADAMS RD
Second Line : STE A
City : ROCHESTER
State : MI
Zip : 48306-1416
Country : US
Telephone Number : 248-475-4301
Fax Number : 248-475-4305
Provider Business Practice Location Address
First Line : 4986 ADAMS RD
Second Line : STE A
City : ROCHESTER
State : MI
Zip : 48306-1416
Country : US
Telephone Number : 248-475-4301
Fax Number : 248-475-4305
Authorized Official
Title or Position : PHYSICIAN
Name : AL JUOCYS
Credential : DO
Telephone Number : 248-475-4301
Provider Enumeration Date : 04/06/2006
Last Update Date : 03/11/2010

Similar Medicare Providers

1861489502 — MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT
Practice Location Address:
4986 N. ADAMS RD. , SUITE D
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-4880
Practice Fax: 248-475-5777
1194792168 — COUNTRY CREEK PEDIATRICS, PLLC
Practice Location Address:
4986 N ADAMS RD , SUITE C
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-5601
Practice Fax: 248-475-5632
1083682777 — PAMELA LAURA COX M.D.
Practice Location Address:
4986 N ADAMS RD , SUITE C
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-5601
Practice Fax: 248-475-5632
1922076512 — DENNIS W FURLONG PA-C
Practice Location Address:
4986 N ADAMS RD , SUITE C
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-5601
Practice Fax: 248-475-5632
1871561944 — ELZBIETA ANNA ROZMIEJ M.D.
Practice Location Address:
4986 N ADAMS RD , SUITE C
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-5601
Practice Fax: 248-475-5632
1013967595 — PADMAVATHI SWAMINATHAN GANAPATHY M.D.
Practice Location Address:
4986 N ADAMS RD , STE C
ROCHESTER, MI
48306-1416
Practice Phone: 248-475-5601
Practice Fax: 248-475-5632

Directions to “COUNTRY CREEK FAMILY PHYSICIANS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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