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General NPI Number Information
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NPI Number | 1972503902
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Entity Type | Organization
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Legal Business Name | WARREN URGENT CARE PC
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 31700 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-7949
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Country | US
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Telephone | 586-276-8200
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Fax | 586-276-8181
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Provider Business Mailing Address
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Address Line | L-4372
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City | COLUMBUS
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State | OH
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Zip | 43260-0001
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Country | US
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Telephone | 586-276-8200
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Fax | 586-276-8181
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. FARAH IFTIKHAR
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Credential | MD
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Telephone | 586-276-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301065784
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 4301065784
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301065784
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License Number State | MI
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