MEDICARE: AS MEDICAL GROUP MADISON HEIGHTS URGENT CARE PLC

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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1700472644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AS MEDICAL GROUP MADISON HEIGHTS URGENT CARE PLC

Provider Business Mailing Address
First Line	:	32600 JOHN R RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1338
Country	:	US
Telephone Number	:	248-307-7796
Fax Number	:	248-307-7801

Provider Business Practice Location Address
First Line	:	32600 JOHN R RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1338
Country	:	US
Telephone Number	:	248-307-7796
Fax Number	:	248-307-7801

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. ROLA PAPIO
Credential	:
Telephone Number	:	734-353-1346

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	01/12/2021

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