Southeastern Michigan Medical Consultants Pc

LBN: Southeastern Michigan Medical Consultants Pc
Southeastern Michigan Medical Consultants Pc is an health care organization with primary practice located at 21420 Harper Ave Suite 2, Saint Clair Shores MI 48080-3607. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as the primary health care specialty. Southeastern Michigan Medical Consultants Pc can be contacted via phone (586) 775-7400, or through Vervaeke, Rudy Jerome via phone (586) 775-7400.

Contact Information

Primary practice address
21420 Harper Ave Suite 2 Saint Clair Shores MI 48080-3607
Fax: (586) 775-0091
Website:
Authorized official contact:
Name: Vervaeke, Rudy Jerome Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 4301044898 Michigan

Profile Details

NPI number 1942300884
LBN Legal business name Southeastern Michigan Medical Consultants Pc
DBA Doing business as
Authorized official Vervaeke, Rudy Jerome Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 22nd, 2006
Last updated Feb 6th, 2015 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942300884 NPPES
Michigan Other 4329604 AETNA
Michigan Other 010E023690 AETNA
Michigan Other B47051 AETNA
Michigan Other DE9629 AETNA
Michigan Other 010E023690 AETNA
Michigan MEDICAID 1942300884 AETNA

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