Healthcare Provider Details

I. General information

NPI: 1548607971
Provider Name (Legal Business Name): EXPRESS URGENT CARE,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2013
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8434 N SAGINAW RD
MOUNT MORRIS MI
48458-1190
US

IV. Provider business mailing address

8434 N SAGINAW RD
MOUNT MORRIS MI
48458-1190
US

V. Phone/Fax

Practice location:
  • Phone: 810-686-1997
  • Fax: 810-686-1820
Mailing address:
  • Phone: 810-686-1997
  • Fax: 810-686-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301083199
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704110505
License Number StateMI

VIII. Authorized Official

Name: DR. MOHAMAD L ALASBAHI
Title or Position: OWNER
Credential: M.D.
Phone: 810-686-1997