ST. CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC (NPI# 1528587854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528587854 |
| Entity Type | Organization |
| Organization Name | ST. CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC |
| Practice Address |
23829 Little Mack Ave Ste 100 Saint Clair Shores MI 48080-1186 |
| Practice Telephone | (586) 773-1300 |
| Mailing Telephone | 5867731300 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-10-25 |
| Authorized Official Name | KANWALDEEP SIDHU (MD) |
| Authorized Official Telephone | 5865524571 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS DME PIN | 0E05556 | 01 |
| MI | BCBS PIN | 0E02122 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570171 | St. Clair Orthopaedics and Sports Medicine PC | Orthopaedic Surgery | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2019-10-23 |
| Street Address |
23829 LITTLE MACK AVE STE 100 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-1186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902061419 | Kirk Gregory Cleland | Orthopaedic Surgery | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2008-07-23 |
| 1215570171 | St. Clair Orthopaedics and Sports Medicine PC | Orthopaedic Surgery | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2019-10-23 |
| 1427690734 | Stefan M Smolenski | Nurse Practitioner | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2019-10-09 |
| 1558774752 | Karine Yu | Physical Medicine & Rehabilitation | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2014-06-04 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902061419 | Kirk Gregory Cleland | Orthopaedic Surgery | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2008-07-23 |
| 1326019399 | Jeffrey Zacharias | Orthopaedic Surgery | 25631 Little Mack Ave Ste 102, Saint Clair Shores, MI 48081-2100 | 2006-01-30 |
| 1215570171 | St. Clair Orthopaedics and Sports Medicine PC | Orthopaedic Surgery | 23829 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1186 | 2019-10-23 |
| 1124368923 | Jonathon Hinz | Orthopaedic Surgery | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080 | 2013-02-15 |
| 1437420924 | James Zurawski | Orthopaedic Surgery | 24715 Little Mack Ave, Ste. 100, Saint Clair Shores, MI 48080-3207 | 2012-01-16 |
| 1699909960 | Matthew Michael Brewster | Orthopaedic Surgery | 24715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-3207 | 2009-05-14 |
| 1831365477 | Mark Andrew Bergin | Orthopaedic Surgery | 23829 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-1186 | 2008-05-04 |
| 1851577316 | Leo Patrick Stephens | Orthopaedic Surgery | 25631 Little Mack Ave, Ste 202, Saint Clair Shores, MI 48081-2100 | 2008-01-15 |
| 1629252689 | Samer George Saqqa | Orthopaedic Surgery | 24715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-3207 | 2007-12-26 |
| 1871799833 | Andrew Farris Ajluni | Orthopaedic Surgery | 24715 Little Mack Ave, Suite 100, Saint Clair Shores, MI 48080-3207 | 2007-06-26 |
| 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 ORTHOPAEDICS AND SPORTS MEDICINE PC.
| 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.