Provider Demographics
NPI:1568817534
Name:WAYNE URGENT CARE PLLC
Entity type:Organization
Organization Name:WAYNE URGENT CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:NABEEL
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-389-7103
Mailing Address - Street 1:34815 W MICHIGAN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1799
Mailing Address - Country:US
Mailing Address - Phone:734-389-7103
Mailing Address - Fax:
Practice Address - Street 1:34815 W MICHIGAN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1799
Practice Address - Country:US
Practice Address - Phone:734-389-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAYNE URGENT CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty