Healthcare Provider Details

I. General information

NPI: 1063676237
Provider Name (Legal Business Name): MEADOWBROOK URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33722 WOODWARD AVE
BIRMINGHAM MI
48009-0912
US

IV. Provider business mailing address

PO BOX 2064
PRAIRIEVILLE LA
70769-2064
US

V. Phone/Fax

Practice location:
  • Phone: 248-919-4900
  • Fax: 248-919-4901
Mailing address:
  • Phone: 225-744-8636
  • Fax: 225-313-6012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number5101013830
License Number StateMI

VIII. Authorized Official

Name: MR. YISROEL SIGLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 248-476-8500