Provider Demographics
NPI:1588837454
Name:AMBUCARE CLINIC P.C.
Entity Type:Organization
Organization Name:AMBUCARE CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:KONDUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-978-7638
Mailing Address - Street 1:24249 AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5707
Mailing Address - Country:US
Mailing Address - Phone:248-978-7638
Mailing Address - Fax:
Practice Address - Street 1:12125 CONANT ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2718
Practice Address - Country:US
Practice Address - Phone:313-891-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care