Provider Demographics
NPI:1619920253
Name:NOVI URGENT CARE PLLC
Entity Type:Organization
Organization Name:NOVI URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:A
Authorized Official - Last Name:NASRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-946-4500
Mailing Address - Street 1:43535 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1108
Mailing Address - Country:US
Mailing Address - Phone:248-946-4500
Mailing Address - Fax:248-946-4503
Practice Address - Street 1:43535 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1108
Practice Address - Country:US
Practice Address - Phone:248-946-4500
Practice Address - Fax:248-946-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052864207R00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty