Healthcare Provider Details

I. General information

NPI: 1699854661
Provider Name (Legal Business Name): EMERGENCY CARE SPECIALISTS OF ST. CLAIR COUNTY, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 ELECTRIC AVE EMERGENCY DEPARTMENT
PORT HURON MI
48060-6587
US

IV. Provider business mailing address

17717 MASONIC
FRASER MI
48026-3158
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-1580
  • Fax:
Mailing address:
  • Phone: 800-531-5788
  • Fax: 586-296-1143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JERE F BALDWIN
Title or Position: PRESIDENT
Credential: M. D.
Phone: 800-531-5788