| LCA CASE NUMBER | I-200-21098-207783 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-08 |
| DECISION DATE | 2021-04-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Port Huron Physicians Medical Group, P.C. |
| TRADE NAME DBA | Lake Huron Medical Group |
| EMPLOYER ADDRESS1 | 2601 Electric Ave. |
| EMPLOYER CITY | Port Huron |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48060 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18102162902 |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | Brown-McCoy |
| EMPLOYER POC FIRST NAME | Julie |
| EMPLOYER POC JOB TITLE | Interim Director LHMG/Manager Business Office, LHMG, CBO |
| EMPLOYER POC ADDRESS 1 | 2601 Electric Ave. |
| EMPLOYER POC CITY | Port Huron |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48060 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18102162902 |
| EMPLOYER POC EMAIL | jbrownmccoy@primehealthcare.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Chary |
| AGENT ATTORNEY FIRST NAME | Siddharth |
| AGENT ATTORNEY MIDDLE NAME | S |
| AGENT ATTORNEY ADDRESS1 | 175 Kent Av. |
| AGENT ATTORNEY ADDRESS2 | 416 |
| AGENT ATTORNEY CITY | Brooklyn |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 11249 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12129608365 |
| AGENT ATTORNEY EMAIL ADDRESS | sid@charylaw.com |
| LAWFIRM NAME BUSINESS NAME | Chary Law P.C. |
|
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 2601 Electric Ave. |
| LCA CASE WORKLOC1 CITY | Port Huron |
| WORKSITE COUNTY | ST CLAIR |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 48060 |
| LCA CASE WAGE RATE FROM | 200000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 79435 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
