Premnath Alfred, M.D

Individual provider Active NPI Family Medicine Physician · Burton, MI

NPI 1487961439 · NPPES record last updated Sep 10, 2010

Key facts

NPI
1487961439
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
4301095953 (MI)
Practice address
1460 N Center Rd
Burton, MI 48509-1429
Phone
(810) 715-4300
NPI assigned
Sep 10, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301095953MIMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301095953 MI Yes

Addresses

Primary practice location

1460 N Center Rd
Burton, MI 48509-1429

Mailing address

1460 N Center Rd
Burton, MI 48509-1429
Phone (810) 715-4300

Other providers in Burton, MI

All providers in Burton, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.