Basic Information
| Provider Information | |||||||||
| NPI: | 1538307574 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHY URGENT CARE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1034 W ANN ARBOR TRL | ||||||||
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| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481701502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346675152 | ||||||||
| FaxNumber: | 7346672579 | ||||||||
| Practice Location | |||||||||
| Address1: | 30488 MILFORD RD | ||||||||
| Address2: | |||||||||
| City: | NEW HUDSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481658583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1111111111 | ||||||||
| FaxNumber: | 1111111111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2009 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | DURHAM | ||||||||
| AuthorizedOfficialFirstName: | CHRISTIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 2488647481 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.