Downriver Clinic PC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

4301091157 Issued in MI

Legal business name

DOWNRIVER CLINIC PC

Practice address

8944 Macomb St
Grosse Ile, MI 48138-2089

Phone

(734) 675-0705

Fax

(734) 675-0747

NPI assigned

Jan 16, 2009

Last updated

Apr 14, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mounir Khaled, MDNPI 1760678809

Title

Owner Medical Director Physician

Phone

(734) 675-0705

Specialties & licenses 1

Addresses

Tax ID family

Downriver Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Downriver Clinic PC

  • Internal Medicine Physician
  • Grosse Ile, MI
  • NPI 1205073285
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mounir Khaled, M.D.

  • Internal Medicine Physician
  • Grosse Ile, MI
  • NPI 1760678809
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1104063817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8944 MACOMB ST",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481382089",
            "telephone_number": "734-675-0705",
            "fax_number": "734-675-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8944 MACOMB ST",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481382089",
            "telephone_number": "734-675-0705",
            "fax_number": "734-675-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNRIVER CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "KHALED",
        "authorized_official_first_name": "MOUNIR",
        "authorized_official_title_or_position": "OWNER MEDICAL DIRECTOR PHYSICIAN",
        "authorized_official_telephone_number": "734-675-0705",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MI",
            "license": "4301091157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Jennifer Crawford, D.C.
• Jonathan Michael Cugini, LMSW
• Sheryl A Czopek, RN
• Dayo Sudiyah Davis
• Kira Lynn Derupa
• Downriver Clinic PC
• Egger Medical PLLC
• Nadia Ibrahim El Khatib, PHARMD
• Eldercare Home Care Group, Inc
• Elizabeth Ann Feirtag, PTA

• Urgent Care Clinic/Center in Grosse Ile, MI
• Providers in Grosse Ile, MI by specialty
• Urgent Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.