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General NPI Number Information
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NPI Number | 1396409454
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Entity Type | Organization
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Legal Business Name | PROMED URGENT CARE PLLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 19041 E 12 MILE RD STE 102
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City | ROSEVILLE
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State | MI
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Zip | 48066-2609
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Country | US
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Telephone | 586-252-2937
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Fax |
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Provider Business Mailing Address
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Address Line | 19041 E 12 MILE RD STE 102
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City | ROSEVILLE
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State | MI
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Zip | 48066-2609
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Country | US
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Telephone | 586-252-2937
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ANKUR PATEL
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Credential | NP
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Telephone | 586-252-2937
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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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