Provider Demographics
NPI:1861746893
Name:WOODWARD URGENT CARE PLLC
Entity type:Organization
Organization Name:WOODWARD URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF BUSINESS
Authorized Official - Prefix:MR
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-758-0730
Mailing Address - Street 1:43344 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5049
Mailing Address - Country:US
Mailing Address - Phone:248-758-0730
Mailing Address - Fax:
Practice Address - Street 1:43344 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5049
Practice Address - Country:US
Practice Address - Phone:248-758-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H70457OtherBLUE CROSS AND BLUE SHIELD OF MICHIGAN