# DOWNRIVER CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104063817
- **Authorized official:** MOUNIR KHALED MD (OWNER MEDICAL DIRECTOR PHYSICIAN)
- **Authorized official phone:** (734) 675-0705

## Contact information

- **Practice address:** 8944 MACOMB ST, GROSSE ILE, MI 48138-2089
- **Practice address phone:** (734) 675-0705
- **Practice address fax:** (734) 675-0747
- **Mailing address:** 8944 MACOMB ST, GROSSE ILE, MI 48138-2089
- **Mailing address phone:** (734) 675-0705
- **Mailing address fax:** (734) 675-0747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | 4301091157 | MI | Yes |

## Other

- **Enumeration date:** 01/16/2009
- **Last updated:** 04/14/2009