Shores Rheumatology PC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

TB038759 Issued in MI

Legal business name

SHORES RHEUMATOLOGY PC

Practice address

24100 Little Mack Ave
Saint Clair Shores, MI 48080-3247

Phone

(586) 777-7577

Fax

(586) 777-6484

NPI assigned

Apr 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy A Brennan, MD

Title

President

Phone

(586) 777-7577

Specialties & licenses 1

Addresses

Tax ID family

Shores Rheumatology PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shores Rheumatology PC

  • Rheumatology Physician
  • Saint Clair Shores, MI
  • NPI 1649490772
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508085168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803247",
            "telephone_number": "586-777-7577",
            "fax_number": "586-777-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803247",
            "telephone_number": "586-777-7577",
            "fax_number": "586-777-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORES RHEUMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-777-7577",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "TB038759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shores Medical Associates PLLC
• Shores of Hope
• Shores Primary Care, P.C.
• Shores Psychiatric Associates, P.C.
• Shores Rheumatology PC
• Shores Rheumatology PC
• Shores Specialty Pharmacy LLC
• Shoreside Family Dental, P.L.C.
• Shout It Out Speech and Language Therapy
• Songfang Shuai I, ACUPUNCTURIST

• Rheumatology Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Rheumatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.