1083875314 NPI number — FAMILY URGENT CARE OF COMMERCE, PLLC

Table of content: HEIDI ROBINSON MPA, MHRM (NPI 1629407200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083875314 NPI number — FAMILY URGENT CARE OF COMMERCE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY URGENT CARE OF COMMERCE, PLLC
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:
1083875314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3005 OLD PLANK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48381-3551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-363-9075
Provider Business Mailing Address Fax Number:
248-363-9087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 UNION LAKE RD
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
COMMERCE TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48382-3500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-363-9075
Provider Business Practice Location Address Fax Number:
248-363-9087
Provider Enumeration Date:
06/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KUZDAK
Authorized Official First Name:
RON
Authorized Official Middle Name:
C
Authorized Official Title or Position:
MEDICAL DIRECTOR/OWNER
Authorized Official Telephone Number:
248-363-9075

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  5101013354 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com