Community Urgent Care Pllc | |
1816 Grindley Park St Dearborn MI 48124-2504 | |
(313) 792-1200 | |
(313) 792-1201 |
Full Name | Community Urgent Care Pllc |
---|---|
Speciality | Family Medicine |
Location | 1816 Grindley Park St, Dearborn, Michigan |
Authorized Official Name and Position | Faiz Rahman (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3137921200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Community Urgent Care Pllc 1816 Grindley Park St Dearborn MI 48124-2504 Ph: (313) 792-1200 | Community Urgent Care Pllc 1816 Grindley Park St Dearborn MI 48124-2504 Ph: (313) 792-1200 |
NPI Number | 1609074665 |
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Provider Enumeration Date | 07/10/2007 |
Last Update Date | 04/09/2013 |
Medicare PECOS PAC ID | 2264525302 |
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Medicare Enrollment ID | O20070906000475 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609074665 | NPI | - | NPPES |
700H238250 | Other | MI | BCBS GROUP |
I41319 | Other | MI | HAP |
0P47330 | Other | MI | MEDICARE PT |
700H238250 | Other | MI | BCN GROUP |
1609074665 | Medicaid | MI | |
DH0360 | Other | MI | RAILROAD MEDICARE GROUP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301080612 (Michigan) | Primary |
Provider Name | Faiz Rahman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598737041 PECOS PAC ID: 0244265478 Enrollment ID: I20050927000937 |
Provider Name | Sumbul F Rahman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316010416 PECOS PAC ID: 0244323848 Enrollment ID: I20070912000127 |
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