Provider Demographics
NPI:1659457802
Name:VALLEY URGENT CARE PC
Entity Type:Organization
Organization Name:VALLEY URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMERER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-791-3888
Mailing Address - Street 1:3061 CHRISTY WAY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2267
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:
Practice Address - Street 1:3020 BOARDWALK DR
Practice Address - Street 2:VALLEY URGENT CARE
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2324
Practice Address - Country:US
Practice Address - Phone:989-791-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003904363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty