Healthcare Provider Details

I. General information

NPI: 1326320599
Provider Name (Legal Business Name): SHELBY URGENT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51850 DEQUINDRE RD SUITE 1
SHELBY TWP MI
48316-2806
US

IV. Provider business mailing address

51850 DEQUINDRE RD SUITE 1
SHELBY TWP MI
48316-2806
US

V. Phone/Fax

Practice location:
  • Phone: 586-799-4082
  • Fax: 586-799-4083
Mailing address:
  • Phone: 586-799-4082
  • Fax: 586-799-4083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FADI DEMASHKIEH
Title or Position: OWNER/ PHYSICIAN
Credential: MD
Phone: 248-561-1291