Provider Demographics
NPI:1689976136
Name:STERLING MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:STERLING MEDICAL CLINIC PLLC
Other - Org Name:STERLING MEDICAL CLINIC URGENT
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-977-3900
Mailing Address - Street 1:13439 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-6304
Mailing Address - Country:US
Mailing Address - Phone:586-977-3900
Mailing Address - Fax:586-977-6084
Practice Address - Street 1:13439 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-6304
Practice Address - Country:US
Practice Address - Phone:586-977-3900
Practice Address - Fax:586-977-6084
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STERLING MEDICAL CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1822Medicare UPIN