Organization · NPI-2
12 And Dequindre Urgent LLC
Clinic/Center, Urgent Care · Madison Heights, MI
NPI number1336829340
StatusActive
Last updated in NPPESJul 24, 2023
Details
- NPI
- 1336829340
- Entity type
- Organization (NPI-2)
- Legal business name
- 12 And Dequindre Urgent LLC
- Organization subpart
- No
- Enumeration date
- Jul 24, 2023
- Certification date
- Jul 24, 2023
- Last updated
- Jul 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QU0200X | Clinic/Center, Urgent Care | – | – | Yes |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | |
| 207R00000X | Internal Medicine | – | – |
Practice location
28373 Dequindre RdMadison Heights, MI 48071-3003
Phone 248-677-3660
Mailing address
28373 Dequindre RdMadison Heights, MI 48071-3003
Phone 248-677-3660
Authorized official
Abdullatif Antoon Yaldo
Owner
2487551248
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