| Livernois Primary And Urgent Care | |
|
18254 Livernois Ave Detroit MI 48221-4214 | |
| (313) 880-1053 | |
| (313) 646-4072 |
| Full Name | Livernois Primary And Urgent Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 18254 Livernois Ave, Detroit, Michigan |
| Authorized Official Name and Position | Jumana F Nagarwala (OWNER) |
| Authorized Official Contact | 3138801053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livernois Primary And Urgent Care 18254 Livernois Ave Detroit MI 48221-4214 Ph: (313) 880-1053 | Livernois Primary And Urgent Care 18254 Livernois Ave Detroit MI 48221-4214 Ph: (313) 880-1053 |
| NPI Number | 1659021509 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 02/17/2023 |
| Medicare PECOS PAC ID | 3779970991 |
|---|---|
| Medicare Enrollment ID | O20220418001885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659021509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Fakhruddin S Attar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114968419 PECOS PAC ID: 0446346001 Enrollment ID: I20071012000628 |
| Provider Name | Jumana F Nagarwala |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619048329 PECOS PAC ID: 6406980127 Enrollment ID: I20100817001173 |
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