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General NPI Number Information
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NPI Number | 1588837454
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Entity Type | Organization
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Legal Business Name | AMBUCARE CLINIC P.C.
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 12125 CONANT ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-2718
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Country | US
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Telephone | 313-891-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 24249 AMANDA LN
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City | NOVI
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State | MI
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Zip | 48375-5707
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Country | US
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Telephone | 248-978-7638
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ASHOK K KONDUR
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Credential | MD
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Telephone | 248-978-7638
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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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