Provider Demographics
NPI:1821649948
Name:HOPE PRIMARY CARE OF BIRCH RUN PLLC
Entity Type:Organization
Organization Name:HOPE PRIMARY CARE OF BIRCH RUN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NUSRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-412-5590
Mailing Address - Street 1:9143 BIRH RUN RD
Mailing Address - Street 2:STE 3
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415
Mailing Address - Country:US
Mailing Address - Phone:989-244-6441
Mailing Address - Fax:989-244-6443
Practice Address - Street 1:9143 BIRH RUN RD
Practice Address - Street 2:STE 3
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415
Practice Address - Country:US
Practice Address - Phone:989-244-6441
Practice Address - Fax:989-244-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care