Provider Demographics
NPI:1083461370
Name:ER DOC URGENT CARE PLLC
Entity type:Organization
Organization Name:ER DOC URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WASFEH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSHEINISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-515-6507
Mailing Address - Street 1:3677 FORT ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-4116
Mailing Address - Country:US
Mailing Address - Phone:313-887-7770
Mailing Address - Fax:
Practice Address - Street 1:3677 FORT ST
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-4116
Practice Address - Country:US
Practice Address - Phone:313-887-7770
Practice Address - Fax:313-254-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty