Provider Demographics
NPI:1265655583
Name:PRIMECARE MEDICAL CENTERS OF MICHIGAN, P.L.L.C.
Entity Type:Organization
Organization Name:PRIMECARE MEDICAL CENTERS OF MICHIGAN, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZELCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-759-1100
Mailing Address - Street 1:22605 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-2358
Mailing Address - Country:US
Mailing Address - Phone:586-759-1100
Mailing Address - Fax:586-759-2721
Practice Address - Street 1:1320 WILKINS ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4802
Practice Address - Country:US
Practice Address - Phone:313-393-2300
Practice Address - Fax:313-387-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care