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General NPI Number Information
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NPI Number | 1689959702
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Entity Type | Organization
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Legal Business Name | MIDMICHIGAN URGENT CARE FREELAND
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 2618 W SUGNET RD
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City | MIDLAND
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State | MI
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Zip | 48640-2647
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Country | US
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Telephone | 989-633-5237
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Fax |
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Provider Business Mailing Address
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Address Line | 5694 MIDLAND RD
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City | FREELAND
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State | MI
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Zip | 48623-8845
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Country | US
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Telephone | 989-695-4999
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RICHARD DRIMALLA
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Credential | MD
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Telephone | 989-633-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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