Provider Demographics
NPI:1770517955
Name:IMMEDIATE CARE MEDICAL CENTER, PC
Entity type:Organization
Organization Name:IMMEDIATE CARE MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-474-3132
Mailing Address - Street 1:21000 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5546
Mailing Address - Country:US
Mailing Address - Phone:248-474-3132
Mailing Address - Fax:248-474-3181
Practice Address - Street 1:21000 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5546
Practice Address - Country:US
Practice Address - Phone:248-474-3132
Practice Address - Fax:248-474-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISK058204207R00000X
MIAR069477207RC0000X
MIKZ063288207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty