MEDICARE: GB URGENT CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1689003113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GB URGENT CARE

Provider Business Mailing Address
First Line	:	8143 S SAGINAW ST
Second Line	:	SUITE 2B
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1825
Country	:	US
Telephone Number	:	810-584-7689
Fax Number	:	810-771-4992

Provider Business Practice Location Address
First Line	:	8143 S SAGINAW ST
Second Line	:	SUITE 2B
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1825
Country	:	US
Telephone Number	:	810-584-7689
Fax Number	:	810-771-4992

Authorized Official
Title or Position	:	SOLE MBR
Name	:	FAISAL M MAWRI
Credential	:	MD
Telephone Number	:	810-584-7689

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	12/31/2013

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