Healthcare Provider Details

I. General information

NPI: 1982146866
Provider Name (Legal Business Name): UNITED TRAUMA CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 W OUTER DR
DETROIT MI
48235-2624
US

IV. Provider business mailing address

PO BOX 639171
CINNCINATI OH
48263-9171
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MANDIP ATWAL
Title or Position: PARTNER
Credential: MD
Phone: 586-596-8884