Provider Demographics
NPI:1619937919
Name:SARATOGA URGENT CARE PC
Entity Type:Organization
Organization Name:SARATOGA URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-527-4000
Mailing Address - Street 1:PO BOX 32588 07
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48232-0588
Mailing Address - Country:US
Mailing Address - Phone:313-527-4000
Mailing Address - Fax:313-527-4004
Practice Address - Street 1:15000 GRATIOT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1973
Practice Address - Country:US
Practice Address - Phone:313-527-4000
Practice Address - Fax:313-527-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065784207Q00000X, 207R00000X
MI4301075100261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4899542Medicaid
MI700H228470OtherBCN
MI110H227950OtherBCBS
MI4858817Medicaid
MIDO4831OtherMEDICARE RAILROAD
MI4899542Medicaid
MI0P30940Medicare PIN