St Clair Adult Medicine Specialists Pc

LBN: St Clair Adult Medicine Specialists Pc
St Clair Adult Medicine Specialists Pc is an health care organization with primary practice located at 23411 Jefferson Ave Suite 100, Saint Clair Shores MI 48080-1949. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. St Clair Adult Medicine Specialists Pc can be contacted via phone (586) 778-4080, or through Hardwicke, Mary Beth via phone (586) 778-4080.

Contact Information

Primary practice address
23411 Jefferson Ave Suite 100 Saint Clair Shores MI 48080-1949
Fax: (586) 778-6055
Website:
Authorized official contact:
Name: Hardwicke, Mary Beth Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MH404922 Michigan

Profile Details

NPI number 1508864620
LBN Legal business name St Clair Adult Medicine Specialists Pc
DBA Doing business as
Authorized official Hardwicke, Mary Beth Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 12th, 2005
Last updated Jul 16th, 2010 - about 14 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 1508864620 NPPES
Michigan MEDICAID 4240936
Michigan MEDICAID 3389123
Michigan Other 110E010920
Michigan MEDICAID 3384323
Michigan MEDICAID 4613977
Michigan MEDICAID 4989630

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