Healthcare Provider Details

I. General information

NPI: 1982528576
Provider Name (Legal Business Name): CLEAR SINUS EAR NOSE AND THROAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15930 19 MILE RD STE 140
CLINTON TOWNSHIP MI
48038-1155
US

IV. Provider business mailing address

3334 ROCHESTER RD # 714
TROY MI
48083-5426
US

V. Phone/Fax

Practice location:
  • Phone: 586-280-1000
  • Fax:
Mailing address:
  • Phone: 248-229-1693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEROLOS G SHENOUDA
Title or Position: OWNER
Credential: MD
Phone: 586-280-1000