Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Panacea Portal LLC

Organization Contractor · NPI 1003559675

Panacea Portal LLC is a Contractor in Burton, Michigan. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6457 Hickory Ln
Burton, MI 48509-9303
Phone: (248) 509-4774
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1003559675
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Rouse — President · (248) 509-4774
NPI enumeratedApril 20, 2022
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022
Mailing address6457 Hickory Ln, Burton, MI 48509-9303

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