OrganizationNeil D Jaddou Md Pc(<Unavail>)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address1615 W Big Beaver Rd, Troy, MI 48084-3539(248) 816-1010PECOS EnrollmentBased on the most recent information from CMS, provider Neil D Jaddou Md Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1679655823Provider TypeOrganizationFull NameNeil D Jaddou Md PcOther Name<Unavail>SubpartNoEnumeration Date10/19/2006Last Updated4/30/2009Contact InformationPractice LocationPractice Address1615 W Big Beaver Rd, Troy, MI 48084-3539Phone(248) 816-1010FaxUnlisted FaxMailing LocationMailing Address1615 W Big Beaver Rd, Troy, MI 48084-3539Phone(248) 816-1010FaxUnlisted FaxAuthorized OfficialNameJaddou, Neil (President)Phone(248) 816-1010Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseNJ065821MichiganProvider IdentifiersIDDescriptionIssuerIDH03134DescriptionOtherIssuerHAPMichiganID0806317921DescriptionOtherIssuerBCBSMichiganID080F339440DescriptionOtherIssuerBC/BSMichiganID124427DescriptionOtherIssuerCARE CHOICESMichigan