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General NPI Number Information
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NPI Number | 1295987626
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Entity Type | Organization
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Legal Business Name | MANOR URGENT CARE, PC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 10645 W WARREN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-8009
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Country | US
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Telephone | 313-945-9393
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Fax | 313-945-9122
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Provider Business Mailing Address
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Address Line | 10645 W WARREN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-8009
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Country | US
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Telephone | 313-945-9393
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Fax | 313-945-9122
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HUSSEIN H AJROUCHE
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Credential | MD
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Telephone | 313-244-2589
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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 | 4301083964
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License Number State | MI
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