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General NPI Number Information
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NPI Number | 1184968679
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Entity Type | Organization
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Legal Business Name | AMD URGENT MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 11307 N. LINDEN RD SUITE B
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City | CLIO
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State | MI
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Zip | 48420
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Country | US
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Telephone | 810-533-1468
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Fax |
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Provider Business Mailing Address
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Address Line | 11307 N LINDEN RD SUITE B
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City | CLIO
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State | MI
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Zip | 48420-8501
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Country | US
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Telephone | 810-564-7995
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Fax | 810-564-7999
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Authorized Official
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Title or Position | OPERATION MANAGER
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Name | PAUL MASSIMINO
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Credential |
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Telephone | 810-564-7995
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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 | D55758
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License Number State | MI
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