Healthcare Provider Details

I. General information

NPI: 1821902677
Provider Name (Legal Business Name): URGENT CARE WARREN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30736 HOOVER RD
WARREN MI
48093-2555
US

IV. Provider business mailing address

30736 HOOVER RD
WARREN MI
48093-2555
US

V. Phone/Fax

Practice location:
  • Phone: 313-231-9670
  • Fax:
Mailing address:
  • Phone: 313-231-9670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MOHAMMED ISLAM
Title or Position: OWNER
Credential:
Phone: 313-231-9670