Southeastern Michigan Medical Consultants Pc in Saint Clair Shores - Addiction Medicine
Southeastern Michigan Medical Consultants Pc - NPI 1942300884
Southeastern Michigan Medical Consultants Pc is a Addiction Medicine in Saint Clair Shores, Michigan. Southeastern Michigan Medical Consultants Pc practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Southeastern Michigan Medical Consultants Pc is 1942300884. The last update date is 2015-02-06.
Southeastern Michigan Medical Consultants Pc's current location address is 21420 Harper Ave, Saint Clair Shores, Michigan. You can contact this provider via phone number 5867757400 and fax number 5867750091. The mailing address for Southeastern Michigan Medical Consultants Pc is 21420 Harper Ave, Saint Clair Shores, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southeastern Michigan Medical Consultants Pc |
|---|---|
| Address | 21420 Harper Ave, Saint Clair Shores, Michigan |
| Phone Number | 5867757400 |
| Fax Number | 5867750091 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Vervaeke Jerome Rudy |
| Credentials | MD |
| Telephone Number | 5867757400 |
NPI Number Detail
| NPI Number | 1942300884 |
|---|---|
| Provider Enumeration Date | 2006-09-22 |
| Last Updated Date | 2015-02-06 |
Provider Mailing Address Detail
| Address | 21420 Harper Ave |
|---|---|
| City | Saint Clair Shores |
| State | Michigan (MI) |
| Post Code | 480803607 |
| Phone Number | 5867757400 |
| Fax Number | 5867750091 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 207Ra0401X |
| Licence No | 4301044898 |
|
Definition: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualification |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4329604 | MI | AETNA | |
| 010E023690 | MI | BCBS | |
| B47051 | MI | HAP | |
| DE9629 | MI | RAILROAD MEDICARE GROUP | |
| 010E023690 | MI | BCN | |
| 1942300884 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Southeastern Michigan Medical Consultants Pc by the Centers for Medicare & Medicaid Services?
The Southeastern Michigan Medical Consultants Pc has been assigned the NPI (National Provider Identifier) 1942300884 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Southeastern Michigan Medical Consultants Pc is geographically located?
The Southeastern Michigan Medical Consultants Pc is physically situated at the following location: 21420 Harper Ave, Saint Clair Shores, MI, 480803607.
What is Southeastern Michigan Medical Consultants Pc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Southeastern Michigan Medical Consultants Pc's area of specialization is Addiction Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Ra0401X.
On what date did Southeastern Michigan Medical Consultants Pc receive its 1942300884 assignment from the Centers for Medicare & Medicaid Services?
The Southeastern Michigan Medical Consultants Pc was assigned its 1942300884 on 2006-09-22, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Southeastern Michigan Medical Consultants Pc's details last updated?
The information pertaining to the Southeastern Michigan Medical Consultants Pc, including its address, specialty, and other details, was most recently updated on 2015-02-06.