=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265101059
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSAL CARE SURGICAL CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2021
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5456 15 MILE RD STE 102
-----------------------------------------------------
City | STERLING HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48310-5110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-800-5095
-----------------------------------------------------
Fax | 313-572-0811
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 44056 MOUND RD STE 105
-----------------------------------------------------
City | STERLING HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48314-1357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-572-0810
-----------------------------------------------------
Fax | 313-572-0811
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING MANAGER
-----------------------------------------------------
Name | NAJUD MASHGARI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-642-3777
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------