Organization
ST. JOHN HOSPITAL AND MEDICAL CENTER
Active
Other names
Masonic Urgent Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JOHNSON (DIRECTOR)
(586) 228-4560
Entity
Organization
Contact information
Practice address
21099 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-1045
(586) 296-6213
(586) 296-8180
Mailing address
21099 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-1045
(586) 296-6213
(586) 296-8180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MI
261QU0200X
Urgent Care Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E014700
BCBS GROUP NUMBER
MI
01
—
700E031610
BCBS GROUP NUMBER
MI
01
—
700E034110
BCBS GROUP NUMBER
MI
Enumeration date
09/08/2008
Last updated
12/12/2012
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