Healthcare Provider Details

I. General information

NPI: 1194133769
Provider Name (Legal Business Name): WAYNE URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 01/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34815 W MICHIGAN AVE SUITE1
WAYNE MI
48184-1799
US

IV. Provider business mailing address

34815 W MICHIGAN AVE SUITE 1
WAYNE MI
48184-1799
US

V. Phone/Fax

Practice location:
  • Phone: 734-389-7103
  • Fax:
Mailing address:
  • Phone: 734-389-7103
  • 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: M NABEEL SHAHID
Title or Position: MANAGER
Credential:
Phone: 734-389-7103