Healthcare Provider Details
I. General information
NPI: 1497080741
Provider Name (Legal Business Name): AMERICAN CURRENT CARE OF MICHIGAN, P.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7960 GRAND RIVER RD SUITE 100
BRIGHTON MI
48114-7330
US
IV. Provider business mailing address
5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 810-225-9800
- Fax: 810-225-9807
- Phone: 972-364-8000
- Fax: 214-775-4502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOM
FOGARTY
Title or Position: PRESIDENT
Credential: MD
Phone: 972-364-8000