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SHORES MEDICAL ASSOCIATES PLLC NPI 1316104094


NPI Information

NPI: 1316104094
Provider Name: SHORES MEDICAL ASSOCIATES PLLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
25200 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (586) 774-8720
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SHORES MEDICAL ASSOCIATES PLLC is an internal medicine in Saint Clair Shores, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SHORES MEDICAL ASSOCIATES PLLC NPI is 1316104094. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

25200 LITTLE MACK AVE
SAINT CLAIR SHORES, MI
ZIP 48081-116
Phone: (586) 774-8720
Fax: (586) 774-7154

The provider's authorized official is Arnold Edwin Ketels .
The authorized official title is Cfo and has the following contact phone number (586) 774-8720.

The enumeration date for this NPI number is 5/20/2008 and was last updated on 5/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineCK008071MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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