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
Phone: (586) 778-4080
Fax: (586) 778-6055
Website:
Authorized official contact:
Name: Hardwicke, Mary Beth Doctor of Medicine (MD)
Phone: (586) 778-4080
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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