Abelardo G Contreras MD PC
Organization Active NPI Neurology Physician · Warren, MI
NPI 1417115809 · NPPES record last updated Nov 7, 2012
Key facts
- NPI
- 1417115809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 4301038584
- Legal business name
- ABELARDO G CONTRERAS MD PC
- Practice address
- 29135 Ryan Road
Suite B
Warren, MI 48092-4279 - Phone
- (586) 558-5666
- Fax
- (586) 558-9333
- NPI assigned
- Jun 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Abelardo G Contreras, MD
- Title
- President
- Phone
- (248) 689-7100
Practitioners 2
-
Abelardo G. Contreras, M. D.
-
Luis E. Bustos, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120510000578 | MI | Part B Supplier - Clinic/Group Practice | 8325200207 |
Receives reassigned benefits from 1 practitioner Practice locations: Detroit, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | AC038584 | MI | |
| Neurology Physician |
2084N0400X | 4301038584 | Yes |
Addresses
Primary practice location
29135 Ryan Road
Suite B
Warren, MI 48092-4279
Mailing address
P.O. Box 252375
West Bloomfield, MI 48325-2375
Phone (586) 558-5666
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1430383 | Medicaid | MI |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.