MEDICARE: JUNCTION CLINIC

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	207Q00000X	Family Medicine Physician	GU005238	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0P01030	OTHER	MI	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0258220204	OTHER	MI	BCBS NUMBER
3	1477523892	OTHER	MI	NPI INDIVIDUAL NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285813154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNCTION CLINIC

Provider Business Mailing Address
First Line	:	4771 MICHIGAN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48210-3247
Country	:	US
Telephone Number	:	313-897-2600
Fax Number	:	313-897-2424

Provider Business Practice Location Address
First Line	:	4771 MICHIGAN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48210-3247
Country	:	US
Telephone Number	:	313-897-2600
Fax Number	:	313-897-2424

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JERRY UZANSKY
Credential	:	D.O.
Telephone Number	:	313-897-2600

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	04/20/2008

Similar Medicare Providers

1477523892 — DR. JERRY UZANSKY D.O.
Practice Location Address:

4771 MICHIGAN AVE
DETROIT, MI
48210-3247

Practice Phone: 313-897-2600
Practice Fax: 313-897-2424

1164492500 — DR. JEROME SITNER D.O.
Practice Location Address:

4771 MICHIGAN AVE
DETROIT, MI
48210-3247

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Practice Fax: 313-897-2424

1073702908 — HEALTH CHOICE PHYSICAL THERAPY, P.C.
Practice Location Address:

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DETROIT, MI
48210-3247

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1639301898 — JOHN CHARLES STABB PAC
Practice Location Address:

4771 MICHIGAN AVE
DETROIT, MI
48210-3247

Practice Phone: 313-897-2600
Practice Fax: 313-897-2424

1205158334 — MR. SUBBIAH GANDHI-SUBRAMANIAN P.T.
Practice Location Address:

4745 MICHIGAN AVE
DETROIT, MI
48210-3247

Practice Phone: 313-899-3703
Practice Fax: 313-899-3713

1689940397 — HEART AND VASCULAR CARE, P.C.
Practice Location Address:

4771 MICHIGAN AVE
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48210-3247

Practice Phone: 313-897-2140
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Directions to “JUNCTION CLINIC ” Practice Location

Language	Start Address	Practice Location

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