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General NPI Number Information
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NPI Number | 1487252458
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Entity Type | Organization
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Legal Business Name | MIDLAND EXPRESS URGENT AND FAMILY CARE PLC
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 600 CAMBRIDGE ST STE 1
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City | MIDLAND
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State | MI
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Zip | 48642-4508
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Country | US
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Telephone | 989-486-3682
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CAMBRIDGE ST STE 1
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City | MIDLAND
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State | MI
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Zip | 48642-4508
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Country | US
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Telephone | 989-486-3682
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MR. JOHN ERIC ROBERTS
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Credential | PA-C
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Telephone | 989-708-9074
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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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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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