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General NPI Number Information
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NPI Number | 1760455513
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Entity Type | Individual
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Provider Name | SARAH BETHANY MCDADE MD
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Gender | Female
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 27209 LAHSER RD SUITE 221
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City | SOUTHFIELD
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State | MI
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Zip | 48034-8401
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Country | US
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Telephone | 248-569-2000
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Fax | 248-569-2008
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Provider Business Mailing Address
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Address Line | 1405 BALMORAL DR
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City | DETROIT
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State | MI
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Zip | 48203-1442
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Country | US
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Telephone | 313-622-5662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 4301074905
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License Number State | MI
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