Provider Demographics
NPI:1326070897
Name:MIDMICHIGAN URGENT CARE
Entity Type:Organization
Organization Name:MIDMICHIGAN URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:DRIMALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-633-1350
Mailing Address - Street 1:3009 N SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4555
Mailing Address - Country:US
Mailing Address - Phone:989-633-1350
Mailing Address - Fax:989-633-1355
Practice Address - Street 1:3009 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4555
Practice Address - Country:US
Practice Address - Phone:989-633-1350
Practice Address - Fax:989-633-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1664909Medicaid
MIG37556Medicare UPIN
MII42451Medicare UPIN
MIA78618Medicare UPIN
MIG12607Medicare UPIN
MIF29812Medicare UPIN
MI1664909Medicaid
MIR66464Medicare UPIN
MIE49388Medicare UPIN