Provider Demographics
NPI:1790421253
Name:ULTIMATE PRIORITY PLUS CLINIC LLC
Entity Type:Organization
Organization Name:ULTIMATE PRIORITY PLUS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABBASS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMZE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:313-415-2500
Mailing Address - Street 1:8188 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:313-454-4105
Practice Address - Street 1:8188 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1433
Practice Address - Country:US
Practice Address - Phone:313-415-2500
Practice Address - Fax:313-454-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty