Healthcare Provider Details

I. General information

NPI: 1528832318
Provider Name (Legal Business Name): SUNSHINE FAMILY CARES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 11/13/2023
Certification Date: 11/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3169 BEECHER RD STE 100
FLINT MI
48532-3611
US

IV. Provider business mailing address

G3169 BEECHER RD STE 104
FLINT MI
48532-3644
US

V. Phone/Fax

Practice location:
  • Phone: 810-620-0250
  • Fax: 810-620-0255
Mailing address:
  • Phone: 810-620-0250
  • Fax: 810-620-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEYDA M SU HAM
Title or Position: PRESIDENT
Credential: DO
Phone: 810-620-0250