Provider Demographics
NPI:1780904417
Name:CHARLOTTE MEDICAL CENTER & URGENT CARE
Entity type:Organization
Organization Name:CHARLOTTE MEDICAL CENTER & URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KASSEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:517-543-7800
Mailing Address - Street 1:616 MEIJER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-8376
Mailing Address - Country:US
Mailing Address - Phone:517-543-7800
Mailing Address - Fax:517-543-7900
Practice Address - Street 1:616 MEIJER DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-8376
Practice Address - Country:US
Practice Address - Phone:517-543-7800
Practice Address - Fax:517-543-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care