Provider Demographics
NPI:1093388159
Name:MEDPRO URGENT CARE PLLC
Entity Type:Organization
Organization Name:MEDPRO URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUEDISUELI
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:248-850-8306
Mailing Address - Street 1:31005 JOHN R RD STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1907
Mailing Address - Country:US
Mailing Address - Phone:248-850-8306
Mailing Address - Fax:
Practice Address - Street 1:31005 JOHN R RD STE A
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1907
Practice Address - Country:US
Practice Address - Phone:248-850-8306
Practice Address - Fax:248-808-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care