Provider Demographics
NPI:1659021509
Name:SMS MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:SMS MEDICAL GROUP PLLC
Other - Org Name:LIVERNOIS PRIMARY AND URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUMANA
Authorized Official - Middle Name:F
Authorized Official - Last Name:NAGARWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-880-1053
Mailing Address - Street 1:18254 LIVERNOIS AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-4214
Mailing Address - Country:US
Mailing Address - Phone:313-880-1053
Mailing Address - Fax:313-646-4072
Practice Address - Street 1:18254 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-4214
Practice Address - Country:US
Practice Address - Phone:313-880-1053
Practice Address - Fax:313-646-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty