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PHYSICIAN HEALTHCARE NETWORK, PC
NPI 1639385784
Clinic/Center - Urgent Care in Fort Gratiot, MI

Active since May 15, 2007CLIA 23D0364243 · Waiver
4190 24TH AVE, FORT GRATIOT, MI 48059(810) 989-7788(810) 989-7799 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 28, 2022, Aug 9, 2022, Jul 21, 2022 and 2 more (5 updates tracked since 2020).

About Physician Healthcare Network, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYSICIAN HEALTHCARE NETWORK, PC (NPI 1639385784) is a healthcare organization registered as an urgent care in Fort Gratiot, Michigan and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through January 1, 2027 and lists Mimma Cusumano, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1639385784
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NamePHYSICIAN HEALTHCARE NETWORK, PC
Location Address4190 24TH AVEFort Gratiot, MI 48059-3882
Mailing Address3050 Commerce DrFort Gratiot, MI 48059-3819 · (810) 385-4441 · Fax (810) 385-1951
Phone(810) 989-7788
Fax(810) 989-7799
Organization SubpartNo
Authorized OfficialMimma CusumanoDirector Of Finance · (810) 385-8081
Enumeration DateMay 15, 2007
Last NPPES UpdateFebruary 25, 20265 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2026
✔ NPI 1639385784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
4190 24TH AVE, Fort Gratiot, MI 48059
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0364243

Physician Healthcare Network, PC · Fort Gratiot, MI
Active · expires Jan 1, 2027
CLIA Number23D0364243
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorDaniel Souphis
Laboratory Phone(810) 989-7788
Laboratory LocationPhysician Healthcare Network, PC4190 24th Avenue, Fort Gratiot, MI 48059
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEVERLIE HOUSER AGPCNP-BC
Nurse Practitioner (Gerontology)
4190 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7788
PRIME GARDEN CITY MEDICAL GROUP
Internal Medicine
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
St. Clair County (810) 216-4000
FARRUKH ZAMAN NAQVI M.D.
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7788
NEUROSLEEP CENTER PLLC
Psychiatry & Neurology (Sleep Medicine)
4190 24TH AVE, SUITE 210
FORT GRATIOT, MI 48059
St. Clair County (810) 216-1901
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Clinic/Center (Ambulatory Surgical)
4190 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7700
DANIEL C SOUPHIS D.O.
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7788
FAHIM K IBRAHIM M.D., P.C.
Specialist
4190 24TH AVE, SUITE 204
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7702
CHRISTOPHER J BORGIEL M.D.
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
St. Clair County (810) 989-7788

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Physician Healthcare Network, PC's NPI number?

The NPI number for Physician Healthcare Network, PC is 1639385784. It was assigned to this organization in the NPPES registry on May 15, 2007.

Where is Physician Healthcare Network, PC located?

Physician Healthcare Network, PC is located at 4190 24th Ave, Fort Gratiot, MI 48059. The listed phone number is (810) 989-7788.

What is Physician Healthcare Network, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Does Physician Healthcare Network, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0364243) is associated with this NPI, valid through January 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Physician Healthcare Network, PC accept?

Health plans from Blue Care Network of Michigan list Physician Healthcare Network, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Physician Healthcare Network, PC was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.