Organization
IEP MCO ORTHOPEDIC URGENT CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GERALD HALL MD (MANAGER)
(248) 536-2127
Entity
Organization
Contact information
Practice address
6405 TELEGRAPH RD, BLOOMFIELD HILLS, MI 48301-1716
(248) 997-4690
Mailing address
PO BOX 675560, DETROIT, MI 48267-5560
(248) 536-2127
(248) 893-6952
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
03/05/2025
Last updated
03/03/2026
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