Provider Demographics
NPI:1982776738
Name:ROMEO URGENT CARE, PC
Entity Type:Organization
Organization Name:ROMEO URGENT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:STAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-853-2009
Mailing Address - Street 1:67150 VANDYKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48095
Mailing Address - Country:US
Mailing Address - Phone:586-752-0911
Mailing Address - Fax:586-752-0919
Practice Address - Street 1:67150 VANDYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48095
Practice Address - Country:US
Practice Address - Phone:586-752-0911
Practice Address - Fax:586-752-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI083079Medicare UPIN