PORT HURON CLINIC P.C. (NPI# 1093756934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093756934 |
| Entity Type | Organization |
| Organization Name | PORT HURON CLINIC P.C. |
| Practice Address |
1107 Stone St Ste #1 Port Huron MI 48060-3569 |
| Mailing Address |
Po Box 198 Southfield MI 48037-0198 |
| Practice Telephone | 8109828300 |
| Practice Fax Number | 8109828308 |
| Mailing Telephone | 2485695100 |
| Mailing Fax Number | 2485694774 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2008-08-14 |
| Authorized Official Name | MORTIMER LEVIN (DIRECTOR) |
| Authorized Official Telephone | 2485695100 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 003615 | MI | Other Service Providers |
| Street Address |
1107 STONE ST STE #1 |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-3569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821087453 | Vernon Everett Dencklau | Surgery | 1107 Stone St, Suite 1, Port Huron, MI 48060-3569 | 2005-10-17 |
| 1407205719 | Norma Pakulski | Licensed Practical Nurse | 1107 Stone St, Suite 2, Port Huron, MI 48060-3569 | 2016-06-07 |
| 1548635121 | Ali Endocrinology PC | Internal Medicine | 1107 Stone St, Ste 3, Port Huron, MI 48060-3569 | 2015-12-07 |
| 1134599822 | Katherine Susan Kuhn | Acupuncturist | 1107 Stone St, Suite 2, Port Huron, MI 48060-3569 | 2015-10-07 |
| 1669701124 | Best Kids PC | Pediatrics | 1107 Stone St, Suite 5, Port Huron, MI 48060-3569 | 2009-12-12 |
| 1386877124 | Percy H, Mcdonald, M.d., P.C. | Specialist | 1107 Stone St, Suite 4, Port Huron, MI 48060-3569 | 2009-08-27 |
| 1144407321 | Randi J Votava | Nurse Practitioner | 1107 Stone St, Suite 5, Port Huron, MI 48060-3569 | 2008-01-30 |
| 1336322528 | Blue Water Thoracic and Cardiovascular Surgery, Plc | Surgery | 1107 Stone St, Suite 1, Port Huron, MI 48060-3569 | 2007-12-11 |
| 1487780755 | Shamsa Arshad Ali | Internal Medicine | 1107 Stone St, Suite 3, Port Huron, MI 48060-3569 | 2007-02-23 |
| 1861460750 | Percy Mcdonald | Otolaryngology | 1107 Stone St, Suite 4, Port Huron, MI 48060-3569 | 2006-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194101311 | Brittany Rene Kruger | Legal Medicine | 75 Mines Creek Pl, Battle Creek, MI 49015 | 2015-08-11 |
| 1861808594 | Voravut Rungpradubvong | Legal Medicine | 1111 Maiden Lane Ct Apt 106, Ann Arbor, MI 48105-1927 | 2014-07-02 |
| 1851712319 | Shannan Kline | Legal Medicine | 724 W Centre Ave Ste 105, Portage, MI 49024-6306 | 2013-12-30 |
| 1215373899 | Basam Shamoun | Legal Medicine | 43630 Gratiot, Chesterfield, MI 48055 | 2013-05-22 |
| 1184911422 | Complete Physicians Care PC | Legal Medicine | 8635 Nottingham Ct, Ypsilanti, MI 48198-3222 | 2011-07-07 |
| 1174832752 | Kathleen M Chauvin Mdpc | Legal Medicine | 2518 Capital Ave Sw, Ste 4, Battle Creek, MI 49015-4188 | 2010-09-30 |
| 1134438146 | Community Medical Group Inc | Legal Medicine | 9477 N Territorial Rd Ste 100, Dexter, MI 48130-8583 | 2010-09-26 |
| 1205013307 | Carolyn Goodrich Martin | Legal Medicine | 713 4th St, Kalkaska, MI 49646-9506 | 2008-01-31 |
| 1063693083 | Urgent Care One Pllc | Legal Medicine | 6200 Middlebelt Rd, Garden City, MI 48135-2409 | 2007-11-19 |
| 1659569796 | Infusal Direct, Inc. | Legal Medicine | 8315 Grand River Ave, Detroit, MI 48204-2231 | 2007-10-12 |
| Find all providers with the same taxonomy | ||||
| City | PORT HURON |
| Zip Code | 48060 |
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| 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.