Provider Demographics
NPI:1043075260
Name:MD URGENT CARE & FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:MD URGENT CARE & FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AWADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-751-2020
Mailing Address - Street 1:12640 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3520
Mailing Address - Country:US
Mailing Address - Phone:586-751-2020
Mailing Address - Fax:586-745-4756
Practice Address - Street 1:12640 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3520
Practice Address - Country:US
Practice Address - Phone:586-751-2020
Practice Address - Fax:586-745-4756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty