ST CLAIR SHORES OBSTETRICS AND GYNECOLGY, PLC (NPI# 1164535886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164535886 |
| Entity Type | Organization |
| Organization Name | ST CLAIR SHORES OBSTETRICS AND GYNECOLGY, PLC |
| Other Organization Name | SHORES OB/GYN |
| Practice Address |
19714 E 10 Mile Rd Saint Clair Shores MI 48080-1064 |
| Mailing Address |
19714 Ten Mile Road St Clair Shores MI 48080 |
| Practice Telephone | 5867799400 |
| Practice Fax Number | 5867798949 |
| Mailing Telephone | 5867799400 |
| Mailing Fax Number | 5867798949 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CONSTANTINE RAPHTIS (MEMBER) |
| Authorized Official Telephone | 5867799400 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Shores OB/GYN | Doing Business As Name - Organization |
| Street Address |
19714 E 10 MILE RD |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-1064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770110876 | Zoe Siobhan Bates | Midwife | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2020-03-26 |
| 1396185708 | Rachel Mclaurin Matthews | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2013-06-29 |
| 1427125897 | Wontika R. Smith | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-11-29 |
| 1033129630 | Suzanne M Millican | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-08-08 |
| 1932168044 | Stephanie C Flom | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-03-20 |
| 1801867064 | Anne Marie B Mccarren | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215148689 | Regina Frost | Obstetrics & Gynecology | 22050 Mack Ave, Saint Clair Shores, MI 48080-2388 | 2007-05-25 |
| 1346360229 | Joyce Catherine Purakal | Obstetrics & Gynecology | 21000 E 12 Mile Rd Ste 102, Saint Clair Shores, MI 48081-1156 | 2007-04-02 |
| 1396185708 | Rachel Mclaurin Matthews | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2013-06-29 |
| 1508099193 | Compassionate Womens Healthcare | Obstetrics & Gynecology | 22050 Greater Mack Ave, Saint Clair Shores, MI 48080-2388 | 2009-08-28 |
| 1205091071 | Abessinio Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 22811 Greater Mack Ave, Suite 106, Saint Clair Shores, MI 48080-2021 | 2008-07-22 |
| 1821256116 | Susan A. Radtke, M.d., P.C. | Obstetrics & Gynecology | 21321 Harper Ave, Suite A, Saint Clair Shores, MI 48080-2243 | 2008-05-23 |
| 1427125897 | Wontika R. Smith | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-11-29 |
| 1679657613 | Women To Women Health Center PC | Obstetrics & Gynecology | 23715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1181 | 2006-10-25 |
| 1033129630 | Suzanne M Millican | Obstetrics & Gynecology | 19714 E 10 Mile Rd, Saint Clair Shores, MI 48080-1064 | 2006-08-08 |
| 1144237926 | Andrea Maria Abessinio | Obstetrics & Gynecology | 22811 Greater Mack Ave, Suite 106, Saint Clair Shores, MI 48080-2021 | 2006-08-02 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
Please comment or provide details below to improve the information on ST CLAIR SHORES OBSTETRICS AND GYNECOLGY, PLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.