Surgical Specialist Of Michigan Pc
Specialty details in registry · Saint Clair Shores, MI
At a glance
21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116
NPPES record updated Nov 8, 2011. Public records can lag behind changes at a practice.
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Insurance participation and appointment availability are not established by these public records.
Practice location
21000 E 12 Mile Rd Suite 112Saint Clair Shores, MI 48081-1116
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 174400000X
- Enumeration date
- May 1, 2007
- Record updated
- Nov 8, 2011
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
174400000X · Primary
License reported: 4301057707 MI
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
21000 E 12 Mile RdSuite 112
Saint Clair Shores, MI 48081-1116
- Phone
- (586) 771-8900
- Fax
- (586) 771-8901
Mailing address
21000 E 12 MILE RDSUITE 112
SAINT CLAIR SHORES, MI 480811116
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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