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General NPI Number Information
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NPI Number | 1194699918
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Entity Type | Organization
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Legal Business Name | LIV WELL URGENT CARE PLLC
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 7446 WOODWARD AVE STE 104
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City | DETROIT
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State | MI
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Zip | 48202-3317
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Country | US
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Telephone | 313-279-8414
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Fax | 313-761-4949
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Provider Business Mailing Address
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Address Line | 7446 WOODWARD AVE STE 104
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City | DETROIT
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State | MI
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Zip | 48202-3317
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALOR
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Name | DIANA EL MASRI
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Credential |
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Telephone | 248-215-0048
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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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