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General NPI Number Information
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NPI Number | 1265655583
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Entity Type | Organization
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Legal Business Name | PRIMECARE MEDICAL CENTERS OF MICHIGAN, P.L.L.C.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1320 WILKINS ST
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City | DETROIT
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State | MI
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Zip | 48207-4802
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Country | US
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Telephone | 313-393-2300
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Fax | 313-387-0927
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Provider Business Mailing Address
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Address Line | 22605 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48089-2358
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Country | US
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Telephone | 586-759-1100
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Fax | 586-759-2721
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | DR. JAMES MICHAEL ZELCH
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Credential | M.D.
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Telephone | 586-759-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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