Healthcare Provider Details
I. General information
NPI: 1265754683
Provider Name (Legal Business Name): HOPE URGENT CARE ROMULUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2010
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9340 WAYNE RD
ROMULUS MI
48174-1569
US
IV. Provider business mailing address
9340 WAYNE RD
ROMULUS MI
48174-1569
US
V. Phone/Fax
- Phone: 586-744-6660
- Fax:
- Phone: 734-992-3499
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NUSRAT
JAVAID
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 810-412-5590