Provider Demographics
NPI:1972098895
Name:SOMERSET WALK IN CLINIC PLLC
Entity Type:Organization
Organization Name:SOMERSET WALK IN CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NADDAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-488-2273
Mailing Address - Street 1:1500 W BIG BEAVER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3522
Mailing Address - Country:US
Mailing Address - Phone:248-649-4444
Mailing Address - Fax:248-649-4445
Practice Address - Street 1:1500 W BIG BEAVER RD STE 104
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3522
Practice Address - Country:US
Practice Address - Phone:248-649-4444
Practice Address - Fax:248-649-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center