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General NPI Number Information
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NPI Number | 1568942845
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Entity Type | Organization
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Legal Business Name | ST MARY MERCY PHYSICIAN PRACTICES
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 39201 7 MILE RD RM 140
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City | LIVONIA
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State | MI
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Zip | 48152-1079
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Country | US
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Telephone | 734-743-4430
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Fax |
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Provider Business Mailing Address
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Address Line | 14555 LEVAN RD STE 310
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City | LIVONIA
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State | MI
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Zip | 48154-5085
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Country | US
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Telephone | 734-655-2989
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Fax | 734-655-8590
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Authorized Official
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Title or Position | SR REVENUE MANGEMENT ANALYST
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Name | SUSAN LOCKARD
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Credential |
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Telephone | 734-343-0282
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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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