Healthcare Provider Details

I. General information

NPI: 1104449719
Provider Name (Legal Business Name): MEDICAL CARE ONE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2539 ELLSWORTH RD
YPSILANTI MI
48197-5619
US

IV. Provider business mailing address

2539 ELLSWORTH RD
YPSILANTI MI
48197-5619
US

V. Phone/Fax

Practice location:
  • Phone: 734-330-2800
  • Fax: 734-794-3411
Mailing address:
  • Phone: 734-330-2800
  • Fax: 734-794-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAMER A NASRY
Title or Position: MD
Credential:
Phone: 248-496-6679