| Shenandoah Clinic, P.c. | |
|
909 W Maple Rd Suite 100 Clawson MI 48017-1000 | |
| (248) 435-2028 | |
| (248) 435-2099 |
| Full Name | Shenandoah Clinic, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 909 W Maple Rd, Clawson, Michigan |
| Authorized Official Name and Position | Ronald I Rothenberg (PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 2484352028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shenandoah Clinic, P.c. 909 W Maple Rd Suite 100 Clawson MI 48017-1000 Ph: (248) 435-2028 | Shenandoah Clinic, P.c. 909 W Maple Rd Suite 100 Clawson MI 48017-1000 Ph: (248) 435-2028 |
| NPI Number | 1043394877 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043394877 | NPI | - | NPPES |
| 080F319020 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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