Healthcare Provider Details

I. General information

NPI: 1043296296
Provider Name (Legal Business Name): SHOREPOINTE EMERGENCY CARE PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 KERCHEVAL AVE
GROSSE POINTE FARMS MI
48236-3610
US

IV. Provider business mailing address

PO BOX 670660
DETROIT MI
48267-0660
US

V. Phone/Fax

Practice location:
  • Phone: 313-640-2300
  • Fax:
Mailing address:
  • Phone: 866-321-8433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: STEVEN SAUNDUBRAE
Title or Position: PRESIDENT
Credential: DO
Phone: 586-598-8891