Shelbydale Medical Clinic, P.C.

LBN: Shelbydale Medical Clinic, P.C.
Shelbydale Medical Clinic, P.C. is an health care organization with primary practice located at 49221 Van Dyke Ave , Shelby Twp MI 48317-1336. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Shelbydale Medical Clinic, P.C. can be contacted via phone (586) 254-4860, or through Tom, Keith B via phone (586) 254-4860.

Contact Information

Primary practice address
49221 Van Dyke Ave Shelby Twp MI 48317-1336
Phone: (586) 254-4860
Fax: (586) 254-5844
Website:
Map and Directions
Authorized official contact:
Name: Tom, Keith B Doctor of Osteopathy (DO)
Phone: (586) 254-4860

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X KT008999 Michigan

Profile Details

NPI number 1629258488
LBN Legal business name Shelbydale Medical Clinic, P.C.
DBA Doing business as
Authorized official Tom, Keith B Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 9th, 2007
Last updated Nov 9th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629258488 NPPES
Michigan MEDICAID 2646558

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