Healthcare Provider Details

I. General information

NPI: 1023349578
Provider Name (Legal Business Name): HEALTH CARE MEDICAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17141 HAYES ST
DETROIT MI
48205-3559
US

IV. Provider business mailing address

17141 HAYES ST
DETROIT MI
48205-3559
US

V. Phone/Fax

Practice location:
  • Phone: 313-245-1700
  • Fax: 313-245-1701
Mailing address:
  • Phone: 313-245-1700
  • Fax: 313-245-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN SINGLETON
Title or Position: PRESIDENT
Credential:
Phone: 313-245-1700