MEDICARE: SERENA BESHI PA-C

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	363A00000X	Physician Assistant	5601012841	MI

General Provider Information

NPI Number	:	1407669856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA BESHI PA-C

Provider Business Mailing Address
First Line	:	7975 ELDORA
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48324-4722
Country	:	US
Telephone Number	:	248-880-9787
Fax Number	:

Provider Business Practice Location Address
First Line	:	34025 HARPER AVE
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48035-3737
Country	:	US
Telephone Number	:	586-445-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2025
Last Update Date	:	01/29/2025

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