Provider Demographics
NPI:1396017026
Name:HEALTHY URGENT CARE WEST BLOOMFIELD
Entity Type:Organization
Organization Name:HEALTHY URGENT CARE WEST BLOOMFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARMED
Authorized Official - Middle Name:G
Authorized Official - Last Name:SINAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-865-7444
Mailing Address - Street 1:7125 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3616
Mailing Address - Country:US
Mailing Address - Phone:248-865-7444
Mailing Address - Fax:248-865-7469
Practice Address - Street 1:7125 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3616
Practice Address - Country:US
Practice Address - Phone:248-865-7444
Practice Address - Fax:248-865-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty