Healthcare Provider Details

I. General information

NPI: 1558663666
Provider Name (Legal Business Name): NOVI URGENT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43535 GRAND RIVER AVE
NOVI MI
48375-1108
US

IV. Provider business mailing address

43535 GRAND RIVER AVE
NOVI MI
48375-1108
US

V. Phone/Fax

Practice location:
  • Phone: 248-946-4500
  • Fax: 248-946-4503
Mailing address:
  • Phone: 248-946-4500
  • Fax: 248-946-4503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number4301052864
License Number StateMI

VIII. Authorized Official

Name: DR. SAMER NASRY
Title or Position: OWNER
Credential: M.D.
Phone: 248-946-4500