Organization Name: | PRIMECARE MEDICAL CENTERS OF MICHIGAN, P.L.L.C. |
NPI Number: | 1114140423 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES MICHAEL ZELCH (REPRESENTATIVE) |
Mailing Address: | 14671 Telegraph Rd Redford |
State: | MI US |
Postal Code: | 482393300 |
Phone Number: | 3133872100 |
Fax Number: | 3133872103 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 05/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |