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General NPI Number Information
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NPI Number | 1184843898
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Entity Type | Organization
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Legal Business Name | MEADOWBROOK URGENT CARE PC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 33722 WOODWARD AVE
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City | BIRMINGHAM
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State | MI
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Zip | 48009-0912
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Country | US
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Telephone | 248-919-4900
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Fax | 248-919-4901
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Provider Business Mailing Address
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Address Line | 33722 WOODWARD AVE
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City | BIRMINGHAM
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State | MI
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Zip | 48009-0912
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Country | US
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Telephone | 248-919-4900
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Fax | 248-919-4901
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | RONA LITA WADLE
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Credential | DO
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Telephone | 248-476-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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