Healthcare Provider Details

I. General information

NPI: 1407088925
Provider Name (Legal Business Name): AMERICAN CURRENT CARE OF MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11569 E 12 MILE RD
WARREN MI
48093-2645
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 586-582-0018
  • Fax: 586-582-0108
Mailing address:
  • Phone: 972-364-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. W TOM FOGARTY
Title or Position: PRESIDENT
Credential: MD
Phone: 972-364-8000