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General NPI Number Information
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NPI Number | 1669707378
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Entity Type | Organization
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Legal Business Name | MEADOWBROOK URGENT CARE II PC
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 25500 MEADOWBROOK RD SUITE 190
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City | NOVI
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State | MI
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Zip | 48375-1878
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Country | US
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Telephone | 248-476-8500
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Fax | 248-522-0041
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Provider Business Mailing Address
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Address Line | 25500 MEADOWBROOK RD SUITE 190
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City | NOVI
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State | MI
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Zip | 48375-1878
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Country | US
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Telephone | 248-476-8500
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Fax | 248-522-0041
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Authorized Official
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Title or Position | OWNER/ MEDICAL DIRECTOR
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Name | RONA WADLE
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Credential | D.O
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Telephone | 248-476-8500
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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 | 5101013830
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License Number State | MI
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