Healthcare Provider Details

I. General information

NPI: 1982776738
Provider Name (Legal Business Name): ROMEO URGENT CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67150 VANDYKE RD
WASHINGTON MI
48095
US

IV. Provider business mailing address

67150 VANDYKE SUITE 200
WASHINGTON MI
48095
US

V. Phone/Fax

Practice location:
  • Phone: 586-752-0911
  • Fax: 586-752-0919
Mailing address:
  • Phone: 586-752-0911
  • Fax: 586-752-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TABATHA LEANNE STAGE
Title or Position: BILLING MANAGER
Credential: MD
Phone: 248-853-2009