Unknown Individual – Gastroenterology Physician, NPI 1265618102
Gastroenterology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Little Mack Avenue, Saint Clair Shores, Macomb County, Michigan, 48066, United States
SUITE 101
SAINT CLAIR SHORES, MI 480813017
Phone: (586) 447-0700
Fax: (586) 498-0707
Type: Mailing
42645, Garfield Road, Clinton Township, Macomb County, Michigan, 48038, United States
CLINTON TOWNSHIP, MI 480385022
Phone: (586) 447-0700
Fax: (586) 498-0707
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48081)
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