Provider Demographics
NPI:1336476928
Name:ANN ARBOR URGENT CARE, P.C
Entity Type:Organization
Organization Name:ANN ARBOR URGENT CARE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:JOERIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-633-9027
Mailing Address - Street 1:1000 E STADIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4616
Mailing Address - Country:US
Mailing Address - Phone:734-769-3333
Mailing Address - Fax:734-769-6666
Practice Address - Street 1:1000 E STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4616
Practice Address - Country:US
Practice Address - Phone:734-769-3333
Practice Address - Fax:734-769-6666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H11852OtherBLUE CROSS BLUE SHIELD OF MICHIGAN