Organization
SUMMIT URGENT CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MFED MOSELY MD (OWNER)
(586) 598-8115
Entity
Organization
Contact information
Practice address
21844 23 MILE RD, MACOMB, MI 48042-4422
(586) 598-8115
(586) 591-5929
Mailing address
21844 23 MILE ROAD, MACOMB, MI 48042
(586) 598-8115
(586) 591-5929
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061918
HEALTH ALLI PLAN
MI
01
—
061918
HEALTH ALLIANCE PLAN
—
05
—
1215403597
—
MI
01
—
610926900
ACS-OWCP
—
01
—
700E017910
BCBS
—
Enumeration date
11/13/2006
Last updated
11/25/2019
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