MEDICARE: WE ARE FAMILY MEDICAL LLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1275178154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE ARE FAMILY MEDICAL LLC

Provider Business Mailing Address
First Line	:	16800 GREENFIELD RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3703
Country	:	US
Telephone Number	:	313-635-5735
Fax Number	:

Provider Business Practice Location Address
First Line	:	16800 GREENFIELD RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3703
Country	:	US
Telephone Number	:	313-635-5735
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELAINA UNDERWOOD
Credential	:
Telephone Number	:	248-495-9184

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	01/19/2022

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Directions to “WE ARE FAMILY MEDICAL LLC ” Practice Location

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