Provider Demographics
NPI:1841472446
Name:DUNDEE URGENT CARE PC
Entity type:Organization
Organization Name:DUNDEE URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARSIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-823-5900
Mailing Address - Street 1:PO BOX 32588 09
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48232-0588
Mailing Address - Country:US
Mailing Address - Phone:734-823-9500
Mailing Address - Fax:734-823-5425
Practice Address - Street 1:100 POWELL DR
Practice Address - Street 2:SUITE 8
Practice Address - City:DUNDEE
Practice Address - State:MI
Practice Address - Zip Code:48131-8644
Practice Address - Country:US
Practice Address - Phone:734-823-5900
Practice Address - Fax:734-823-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065784207Q00000X, 261QU0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI227034OtherDEPT OF LABOR MI
MI18272OtherHEALTH PLAN OF MI
MIP00610343OtherRAILROAD MEDICARE
MI04965OtherPARAMOUNT
MI612434400OtherDEPT OF LABOR FED
MI700E811670OtherBCN GROUP
MI165987OtherGREAT LAKES
MI110E811580OtherBLUE CROSS BLUE SHIELD
MI1841472446Medicaid
MIDN2395OtherRAILROAD MEDICARE GROUP
MI025449OtherMIDWEST HEALTH PLAN
MI524933710Medicaid
MI82027100OtherPROCARE
MI=========-00OtherOHIO WORK COMP
MI612434400OtherDEPT OF LABOR FED