Provider Demographics
NPI:1477715324
Name:HAMTRAMCK WALK-IN CLINIC
Entity Type:Organization
Organization Name:HAMTRAMCK WALK-IN CLINIC
Other - Org Name:HAMTRAMCK WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAGHDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHWIKANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:3133-658-6602
Mailing Address - Street 1:8544 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3736
Mailing Address - Country:US
Mailing Address - Phone:313-365-8602
Mailing Address - Fax:313-365-8605
Practice Address - Street 1:8544 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3736
Practice Address - Country:US
Practice Address - Phone:313-365-8602
Practice Address - Fax:313-365-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherEIN NUMBER