Provider Demographics
NPI:1326404443
Name:CITY URGENT CARE PC
Entity Type:Organization
Organization Name:CITY URGENT CARE PC
Other - Org Name:DETROIT URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-850-8395
Mailing Address - Street 1:13403 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1387
Mailing Address - Country:US
Mailing Address - Phone:248-850-8395
Mailing Address - Fax:248-850-8495
Practice Address - Street 1:13403 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1387
Practice Address - Country:US
Practice Address - Phone:248-850-8395
Practice Address - Fax:248-850-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082473207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty