Provider Demographics
NPI:1780819573
Name:CHERRY HILL URGENT CARE MD PC
Entity Type:Organization
Organization Name:CHERRY HILL URGENT CARE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VALENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-844-2050
Mailing Address - Street 1:42484 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3401
Mailing Address - Country:US
Mailing Address - Phone:734-844-2050
Mailing Address - Fax:734-844-2272
Practice Address - Street 1:42484 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3401
Practice Address - Country:US
Practice Address - Phone:734-844-2050
Practice Address - Fax:734-844-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101017460OtherSTATE LICENCE