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PHYSICIAN HEALTHCARE NETWORK PC NPI 1093921074


NPI Information

NPI: 1093921074
Provider Name: PHYSICIAN HEALTHCARE NETWORK, PC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 23D0668849

Address:
3350 GRATIOT BLVD
MARYSVILLE, MI
ZIP 48040
Phone: (810) 364-4000
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PHYSICIAN HEALTHCARE NETWORK, PC is an urgent care clinic center in Marysville, MI. PHYSICIAN HEALTHCARE NETWORK, PC NPI is 1093921074. The provider is registered as an organization entity type.

The provider's business location address is:

3350 GRATIOT BLVD
MARYSVILLE, MI
ZIP 48040-121
Phone: (810) 364-4000
Fax: (810) 364-5995

The provider's authorized official is Mimma Cusumano .
The authorized official title is Director Of Finance and has the following contact phone number (810) 385-8081.

The CLIA number assigned to this NPI record is 23D0668849 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/15/2007 and was last updated on 9/28/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/CenterUrgent CareMICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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