# PRIME CARE PHYSICIAN PC

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

## Provider details

- **NPI number:** 1568635282
- **Authorized official:** DR. GIRIJA MARIPUDI MD (OWNER)
- **Authorized official phone:** (248) 583-0960

## Contact information

- **Practice address:** 121 W 13 MILE RD, MADISON HEIGHTS, MI 48071-1857
- **Practice address phone:** (248) 583-0960
- **Practice address fax:** (248) 583-0961
- **Mailing address:** 121 W 13 MILE RD, MADISON HEIGHTS, MI 48071-1857
- **Mailing address phone:** (248) 583-0960
- **Mailing address fax:** (248) 583-0961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 4301066341 | MI | Yes |

## Other

- **Enumeration date:** 04/03/2008
- **Last updated:** 02/25/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4593972 | — | MI |