Provider Demographics
NPI:1700340569
Name:NUCH OF MICHIGAN, INC.
Entity Type:Organization
Organization Name:NUCH OF MICHIGAN, INC.
Other - Org Name:DMC UC - ROSEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-600-4120
Mailing Address - Street 1:115 EASTPARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2311
Mailing Address - Country:US
Mailing Address - Phone:615-600-4074
Mailing Address - Fax:615-309-8341
Practice Address - Street 1:20782 THIRTEEN MILE ROAD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48375
Practice Address - Country:US
Practice Address - Phone:586-204-1994
Practice Address - Fax:615-309-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care