Shelbydale Medical Clinic, P.c.
NPI #1629258488 in Shelby Twp, Michigan
Provider Information
- NPI Number
- 1629258488
- Entity Type
- Organization
- Organization Name
- Shelbydale Medical Clinic, P.c.
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 9, 2007
- Last Updated
- Nov 9, 2007
Practice Location
- Address
- 49221 VAN DYKE AVE
- City
- Shelby Twp
- State
- Michigan
- ZIP Code
- 48317-1336
- Phone
- (586) 254-4860
Authorized Official
- Name
- KEITH B TOM, D.O.
- Title
- PRESIDENT
- Phone
- (586) 254-4860
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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