| Organization Name: | DOWNRIVER CLINIC PC |
| NPI Number: | 1104063817 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOUNIR KHALED (OWNER MEDICAL DIRECTOR PHYSICIAN) |
| Mailing Address: | 8944 Macomb St Grosse Ile |
| State: | MI US |
| Postal Code: | 481382089 |
| Phone Number: | 7346750705 |
| Fax Number: | 7346750747 |
| NPI Enumeration Date: | 01/16/2009 |
| NPI Last Update Date: | 04/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 4301091157 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |