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General NPI Number Information
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NPI Number | 1356047773
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Entity Type | Organization
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Legal Business Name | MEDWORKS URGENT CARE PLLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 19100 GODDARD RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-1156
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Country | US
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Telephone | 313-763-0309
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Fax | 313-771-9947
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Provider Business Mailing Address
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Address Line | 19100 GODDARD RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-1156
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Country | US
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Telephone | 313-763-0309
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | AHMED MIRZA
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Credential | NP
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Telephone | 313-763-0309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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