St Claire Shores Medical Pllc
LBN: St Claire Shores Medical Pllc
St Claire Shores Medical Pllc is an health care organization with primary practice located at 30140 Harper Ave Suite 300, Saint Clair Shores MI 48082-1610. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty.
St Claire Shores Medical Pllc can be contacted via phone (586) 293-1848, or through Shelton, Bernard W via phone (586) 293-1868.
Contact Information
Primary practice address
30140 Harper Ave Suite 300
Saint Clair Shores MI 48082-1610
Phone: (586) 293-1848
Fax: (586) 293-1869
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | 4301088798 | Michigan |
Profile Details
| NPI number | 1316194640 |
|---|---|
| LBN Legal business name | St Claire Shores Medical Pllc |
| DBA Doing business as | |
| Authorized official | Shelton, Bernard W Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 18th, 2008 |
| Last updated | Oct 8th, 2014 - about 11 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 | 1316194640 | NPPES |
| Michigan | Other | 0502329 | BCBS |
| Michigan | Other | 1417032491 | BCBS |
| Michigan | Other | 70-0-F32947-0 | BCBS |
| Michigan | MEDICAID | 4945780-10 | BCBS |
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