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General NPI Number Information
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NPI Number | 1508205329
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Entity Type | Organization
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Legal Business Name | VERNOR URGENT CARE PLLC
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 3456 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48216-1551
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Country | US
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Telephone | 313-254-9693
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Fax | 734-629-1567
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Provider Business Mailing Address
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Address Line | 3456 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48216-1551
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Country | US
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Telephone | 313-254-9693
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Fax | 734-629-1567
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SAMEER ABDURRAHMAN HURAIBI
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Credential | MD
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Telephone | 313-254-9693
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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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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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