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General NPI Number Information
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NPI Number | 1720041288
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Entity Type | Organization
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Legal Business Name | ST CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 23829 LITTLE MACK AVE STE 100
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1186
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Country | US
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Telephone | 586-773-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 22701 HALL RD STE 100
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City | MACOMB
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State | MI
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Zip | 48042-5270
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Country | US
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Telephone | 586-416-4265
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Fax | 586-416-0867
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER L LEE
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Credential | MD
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Telephone | 586-416-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | MI
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