MEDICARE: COMPASSIONATE PRIMARY CARE SERVICES 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1972085926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE PRIMARY CARE SERVICES PLLC

Provider Business Mailing Address
First Line	:	30000 ORCHARD LAKE RD STE B
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2252
Country	:	US
Telephone Number	:	248-851-0500
Fax Number	:	248-851-6006

Provider Business Practice Location Address
First Line	:	30000 ORCHARD LAKE RD STE B
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2252
Country	:	US
Telephone Number	:	248-851-0500
Fax Number	:	248-851-6006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MUNIER A EL-BECK
Credential	:	MD
Telephone Number	:	248-851-0500

Provider Enumeration Date	:	09/05/2018
Last Update Date	:	07/03/2019

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