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NPI Code Detail

MEDICARE: VPS OF MI PLLC

MEDICARE: VPS OF MI PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508417197
Entity Type Code : Organization
Provider Name (Legal Business Name) : VPS OF MI PLLC
Provider Business Mailing Address
First Line : 25880 OUTER DR STE 1
Second Line :
City : LINCOLN PARK
State : MI
Zip : 48146-1553
Country : US
Telephone Number : 248-509-4070
Fax Number : 248-509-4080
Provider Business Practice Location Address
First Line : 25880 OUTER DR STE 1
Second Line :
City : LINCOLN PARK
State : MI
Zip : 48146-1553
Country : US
Telephone Number : 248-509-4070
Fax Number : 248-509-4080
Authorized Official
Title or Position : OWNER
Name : PAYAL JINIT SHAH
Credential : NP-C
Telephone Number : 248-509-4070
Provider Enumeration Date : 09/25/2019
Last Update Date : 09/25/2019

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Directions to “VPS OF MI PLLC ” Practice Location

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