Provider Demographics
NPI:1417216441
Name:CENTRAL MICHIGAN URGENT CARE & WELLNESS CENTER PC
Entity type:Organization
Organization Name:CENTRAL MICHIGAN URGENT CARE & WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MACAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-516-4317
Mailing Address - Street 1:520 N MISSION ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1828
Mailing Address - Country:US
Mailing Address - Phone:989-773-3789
Mailing Address - Fax:989-345-5803
Practice Address - Street 1:611 COURT ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9390
Practice Address - Country:US
Practice Address - Phone:989-516-4317
Practice Address - Fax:989-345-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty