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BLUE WATER URGENT CARE PORT HURON NPI 1548957707


NPI Information

NPI: 1548957707
Provider Name: BLUE WATER URGENT CARE PORT HURON
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 23D2282143

Address:
1612 10TH AVE
PORT HURON, MI
ZIP 48060
Phone: (810) 660-0242
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BLUE WATER URGENT CARE PORT HURON is an urgent care clinic center in Port Huron, MI. BLUE WATER URGENT CARE PORT HURON NPI is 1548957707. The provider is registered as an organization entity type.

The provider's business location address is:

1612 10TH AVE
PORT HURON, MI
ZIP 48060-303
Phone: (810) 660-0242

The provider's authorized official is Ibrahim Dabaja .
The authorized official title is President and has the following contact phone number (810) 660-0242.

The CLIA number assigned to this NPI record is 23D2282143 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2023 and was last updated on 4/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/CenterUrgent CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.