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NPI Code Detail

MEDICARE: CLEARCAST HEARING, LLC

MEDICARE: CLEARCAST HEARING, LLC
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
1207Y00000XOtolaryngology Physician

General Provider Information

NPI Number : 1548134000
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEARCAST HEARING, LLC
Provider Business Mailing Address
First Line : 25704 SHORELINE DR
Second Line :
City : NOVI
State : MI
Zip : 48374-2170
Country : US
Telephone Number : 313-495-7499
Fax Number :
Provider Business Practice Location Address
First Line : 18447 W 8 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-1520
Country : US
Telephone Number : 313-495-7499
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. SREENIVAS CHERUKURI
Credential :
Telephone Number : 313-495-7499
Provider Enumeration Date : 09/30/2025
Last Update Date : 05/06/2026

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