Unknown Individual – Emergency Medicine Physician, NPI 1457587016
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3050, Commerce Drive, Fort Gratiot Charter Township, Saint Clair County, Michigan, 48059, United States
FORT GRATIOT, MI 480593819
Phone: (810) 385-5099
Fax: (810) 385-4933
Type: Mailing
McLaren Port Huron, 1221, Pine Grove Avenue, Port Huron, Saint Clair County, Michigan, 48060, United States
EMERGENCY MEDICINE
PORT HURON, MI 480603511
Phone: (810) 385-5099
Fax: (810) 385-4933
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
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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 ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48059)
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