Healthcare Provider Details

I. General information

NPI: 1487252458
Provider Name (Legal Business Name): MIDLAND EXPRESS URGENT AND FAMILY CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CAMBRIDGE ST STE 1
MIDLAND MI
48642-4508
US

IV. Provider business mailing address

600 CAMBRIDGE ST STE 1
MIDLAND MI
48642-4508
US

V. Phone/Fax

Practice location:
  • Phone: 989-486-3682
  • Fax:
Mailing address:
  • Phone: 989-486-3682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN ERIC ROBERTS
Title or Position: PROVIDER
Credential: PA-C
Phone: 989-708-9074