Provider Demographics
NPI:1184843898
Name:MEADOWBROOK URGENT CARE PC
Entity Type:Organization
Organization Name:MEADOWBROOK URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONA
Authorized Official - Middle Name:LITA
Authorized Official - Last Name:WADLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-476-8500
Mailing Address - Street 1:33722 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-0912
Mailing Address - Country:US
Mailing Address - Phone:248-919-4900
Mailing Address - Fax:248-919-4901
Practice Address - Street 1:33722 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-0912
Practice Address - Country:US
Practice Address - Phone:248-919-4900
Practice Address - Fax:248-919-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F337470OtherBCBSMI
MI5970460001OtherDME PROVIDER NUMBER
MI0P48670Medicare PIN