Healthcare Provider Details

I. General information

NPI: 1417216441
Provider Name (Legal Business Name): CENTRAL MICHIGAN URGENT CARE & WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 COURT ST SUITE A
WEST BRANCH MI
48661-9390
US

IV. Provider business mailing address

520 N MISSION ST
MT PLEASANT MI
48858-1828
US

V. Phone/Fax

Practice location:
  • Phone: 989-516-4317
  • Fax: 989-345-5803
Mailing address:
  • Phone: 989-773-3789
  • Fax: 989-345-5803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD W MACAULEY
Title or Position: OWNER
Credential: MD
Phone: 989-516-4317