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General NPI Number Information
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NPI Number | 1144634924
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Entity Type | Organization
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Legal Business Name | UNITED FAMILY CARE PLLC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 12170 CONANT ST STE C2
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City | HAMTRAMCK
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State | MI
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Zip | 48212-4137
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Country | US
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Telephone | 313-893-6218
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Fax | 313-893-6254
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Provider Business Mailing Address
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Address Line | 12170 CONANT ST STE C2
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City | HAMTRAMCK
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State | MI
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Zip | 48212-4137
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Country | US
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Telephone | 313-893-6218
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Fax | 313-893-6254
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Authorized Official
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Title or Position | PROVIDER
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Name | SHAZIA WADOOD
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Credential | MD
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Telephone | 313-893-6218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | SW079852
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License Number State | MI
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