MEDICARE: SHOREPOINTE EMERGENCY CARE PHYSICIANS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician		MI

General Provider Information

NPI Number	:	1043296296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOREPOINTE EMERGENCY CARE PHYSICIANS PC

Provider Business Mailing Address
First Line	:	PO BOX 670660
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48267-0660
Country	:	US
Telephone Number	:	866-321-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	159 KERCHEVAL AVE
Second Line	:
City	:	GROSSE POINTE FARMS
State	:	MI
Zip	:	48236-3610
Country	:	US
Telephone Number	:	313-640-2300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN SAUNDUBRAE
Credential	:	DO
Telephone Number	:	586-598-8891

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	08/22/2020

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