SHENANDOAH CLINIC P.C. NPI 1043394877

NPI Information

NPI: 1043394877
Provider Name: SHENANDOAH CLINIC, P.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
CLIA Number: 23D0991111
Address: 909 W MAPLE RD
SUITE 100
CLAWSON, MI
ZIP 48017
Phone: (248) 435-2028

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NPI Details

SHENANDOAH CLINIC, P.C. is a family medicine in Clawson, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SHENANDOAH CLINIC, P.C. NPI is 1043394877. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

909 W MAPLE RD
SUITE 100
CLAWSON, MI
ZIP 48017-000
Phone: (248) 435-2028
Fax: (248) 435-2099

The provider's authorized official is Ronald I Rothenberg .
The authorized official title is Physician/president and has the following contact phone number (248) 435-2028.

The CLIA number assigned to this NPI record is 23D0991111 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 2/24/2022.

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
1	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080F319020	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD

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: 11/21/2025

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