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NPI Code Detail

MEDICARE: ST JOHN NORTH SHORES EMERGENCY PHYSICIANS, P. C.

MEDICARE: ST JOHN NORTH SHORES EMERGENCY PHYSICIANS, P. C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1376613638
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST JOHN NORTH SHORES EMERGENCY PHYSICIANS, P. C.
Provider Business Mailing Address
First Line : 17717 MASONIC
Second Line :
City : FRASER
State : MI
Zip : 48026-3158
Country : US
Telephone Number : 800-531-5788
Fax Number :
Provider Business Practice Location Address
First Line : 26755 BALLARD ST
Second Line : EMERGENCY DEPARTMENT
City : HARRISON TOWNSHIP
State : MI
Zip : 48045-2419
Country : US
Telephone Number : 586-465-5501
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. JAMES M FOX
Credential : M. D.
Telephone Number : 800-531-5788
Provider Enumeration Date : 11/08/2006
Last Update Date : 09/24/2008

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Directions to “ST JOHN NORTH SHORES EMERGENCY PHYSICIANS, P. C. ” Practice Location

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