Healthcare Provider Details

I. General information

NPI: 1457301335
Provider Name (Legal Business Name): ROBERT C SESKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26400 OUTER DR
LINCOLN PARK MI
48146-2088
US

IV. Provider business mailing address

198 S MAIN ST SUITE 3
MOUNT CLEMENS MI
48043-7917
US

V. Phone/Fax

Practice location:
  • Phone: 313-594-6000
  • Fax:
Mailing address:
  • Phone: 586-465-2879
  • Fax: 586-465-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301407014
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: