Healthcare Provider Details

I. General information

NPI: 1760455513
Provider Name (Legal Business Name): SARAH BETHANY MCDADE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 BIDDLE AVE
WYANDOTTE MI
48192-6201
US

IV. Provider business mailing address

22200 W 11 MILE RD UNIT 4145
SOUTHFIELD MI
48037-7126
US

V. Phone/Fax

Practice location:
  • Phone: 734-671-1771
  • Fax: 734-287-1413
Mailing address:
  • Phone: 313-622-5662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number4301074905
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: