Michigan-Greenfield Urgent Care PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

BA059825 Issued in MI

Legal business name

MICHIGAN-GREENFIELD URGENT CARE PLLC

Practice address

24355 Ford Rd
Dearborn, MI 48128

Phone

(313) 914-3490

Fax

(313) 908-2301

NPI assigned

Nov 23, 2009

Organization subpart

No

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

Authorized official

Name

Issam Asad, M.D.NPI 1396941332

Title

Owner

Phone

(313) 563-7777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Issam S Asad, M.D.

  • General Practice Physician
  • Keego Harbor, MI
  • NPI 1396941332

  MI

  Medicare reassignment Authorized official
• Belal Fouad Abdallah, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1447230941
  NPD (past)

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1619205028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24355 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48128",
            "telephone_number": "313-914-3490",
            "fax_number": "313-908-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24355 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48128",
            "telephone_number": "313-914-3490",
            "fax_number": "313-908-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN-GREENFIELD URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "ASAD",
        "authorized_official_first_name": "ISSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-563-7777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MI",
            "license": "BA059825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Dearborn, MI
• Urgent Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.