Lakeside Urgent Care, P. C.
Organization Active NPI Urgent Care Clinic/Center · Clinton Township, MI
NPI 1720159304 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1720159304
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- LAKESIDE URGENT CARE, P. C.
- Practice address
- 44472 Hayes Rd
Clinton Township, MI 48038-1090 - Phone
- (586) 412-0890
- Fax
- (586) 412-1065
- NPI assigned
- Nov 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Fadi Demashkieh, MD
- Title
- Owner
- Phone
- (586) 412-0890
Other NPIs on the same Medicare enrollment 1
Practitioners 138
-
Fadi Demashkieh, MD
-
Mohammad Z Al-Sharabi, M. D.
-
Zenobia Nah Arreytta, NURSE PRACTITIONER
-
Lauren Beth Bauer, NP-C
-
Abdullah Bokhari, D.O.
-
Stacey Brooke Cantor, FNP-BC
-
Katie Lee Coaster, NP-C
-
Andrew Damaske, D.O.
-
Mosab Ramzi Muhi Deen, D.O.
-
Timothy Dekker, MD
-
Dominic Carl Fano, D.O.
-
Kathryn Faraj, NP
-
Rudin Gjeka, MD
-
Hollie Gohr, RN, FNP
-
Mary Louise Hasskamp-Howe, MSN-FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226000404 | MI | Part B Supplier - Clinic/Group Practice | 0446146385 |
Receives reassigned benefits from 137 practitioners 1 other NPI on this enrollment Practice locations: Clinton Township, MI |
National Provider Directory
Locations
44472 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 412-0890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | MI | ||
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
44472 Hayes Rd
Clinton Township, MI 48038-1090
Mailing address
44472 Hayes Rd
Clinton Township, MI 48038-1090
Phone (586) 412-0890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ON82490 | Other | MI | HAP |
| 1720159304 | Other | MI | COMMERCIAL |
| 700E001600 | Other | BLUE CARE NETWORK OF MICHIGAN | |
| 1106354161 | Other | MI | BCBS OF MICHIGAN |
| 1720159304 | Medicaid | MI | |
| 700E001600 | Other | MI | BCBS OF MICHIGAN |
Other providers in Clinton Township, MI
- Huanchun Nana Lai
- Ashley Taylor Laine
- Lakeshore Mammography Center PC
- Lakeshore Medical Pharmacy
- Lakeside Center for Implant Dentistry
- Lakeside Urgent Care, P.C.
- Michael K. Lala
- Eric Lalama
- Sandra Lalande
- Han Lam
All providers in Clinton Township, MI · Urgent Care Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.