Healthcare Provider Details

I. General information

NPI: 1780988493
Provider Name (Legal Business Name): HEALING HANDS URGENT CARE MEDICAL CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 05/09/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 ORCHARD LAKE RD
SYLVAN LAKE MI
48320-1749
US

IV. Provider business mailing address

2157 ORCHARD LAKE RD
SYLVAN LAKE MI
48320
US

V. Phone/Fax

Practice location:
  • Phone: 313-561-8796
  • Fax: 313-561-0277
Mailing address:
  • Phone: 248-857-7878
  • Fax: 248-857-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number4301048260
License Number StateMI

VIII. Authorized Official

Name: MOHAMMAD NURUL AMIN
Title or Position: OWNER
Credential: MD
Phone: 248-857-7878