Provider Demographics
NPI:1063872075
Name:UOP URGENT CARE PLLC
Entity type:Organization
Organization Name:UOP URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MED DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAZEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHUSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-277-4330
Mailing Address - Street 1:23822 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3245
Mailing Address - Country:US
Mailing Address - Phone:313-277-4330
Mailing Address - Fax:313-277-4338
Practice Address - Street 1:23822 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3245
Practice Address - Country:US
Practice Address - Phone:313-277-4330
Practice Address - Fax:313-277-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055000207L00000X
MI4301052856207Q00000X
MI4301055667208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI9099Medicare PIN