Provider Demographics
NPI:1003800269
Name:PILLAY INTERNAL MEDICINE ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:PILLAY INTERNAL MEDICINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEET
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-624-2222
Mailing Address - Street 1:100 N POND DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3079
Mailing Address - Country:US
Mailing Address - Phone:248-624-2222
Mailing Address - Fax:248-926-9455
Practice Address - Street 1:100 N POND DR
Practice Address - Street 2:SUITE C
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3079
Practice Address - Country:US
Practice Address - Phone:248-624-2222
Practice Address - Fax:248-926-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION93810Medicare PIN