1841472446 NPI number — DUNDEE URGENT CARE PC

Table of content: (NPI 1841472446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841472446 NPI number — DUNDEE URGENT CARE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUNDEE URGENT CARE PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841472446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 32588 09
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48232-0588
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-823-9500
Provider Business Mailing Address Fax Number:
734-823-5425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 POWELL DR
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
DUNDEE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48131-8644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-823-5900
Provider Business Practice Location Address Fax Number:
734-823-5425
Provider Enumeration Date:
12/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARSIWALA
Authorized Official First Name:
MOHAMMAD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-823-5900

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  4301065784 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 4301065784 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X , with the licence number: 4301065784 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 227034 . This is a "DEPT OF LABOR MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 18272 . This is a "HEALTH PLAN OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P00610343 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 04965 . This is a "PARAMOUNT" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 612434400 . This is a "DEPT OF LABOR FED" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 700E811670 . This is a "BCN GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 165987 . This is a "GREAT LAKES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 110E811580 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1841472446 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: DN2395 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 025449 . This is a "MIDWEST HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 524933710 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 82027100 . This is a "PROCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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