Healthcare Provider Details

I. General information

NPI: 1881048494
Provider Name (Legal Business Name): YPSILANTI URGENT CARE WALK-IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W MICHIGAN AVE SUITE 100
YPSILANTI MI
48197-5450
US

IV. Provider business mailing address

301 W MICHIGAN AVE
YPSILANTI MI
48197-5450
US

V. Phone/Fax

Practice location:
  • Phone: 313-948-3030
  • Fax:
Mailing address:
  • Phone: 313-948-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number06858K
License Number StateMI

VIII. Authorized Official

Name: ABID ABDULLAH
Title or Position: MANAGER
Credential:
Phone: 313-948-3030