Provider Demographics
NPI:1457654675
Name:HARTLAND URGENT CARE PLLC
Entity Type:Organization
Organization Name:HARTLAND URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:IFTIKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-957-7999
Mailing Address - Street 1:34405 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3391
Mailing Address - Country:US
Mailing Address - Phone:248-957-7999
Mailing Address - Fax:249-957-7997
Practice Address - Street 1:11166 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2702
Practice Address - Country:US
Practice Address - Phone:248-957-7999
Practice Address - Fax:248-957-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7301063833173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty