| Organization Name: | ST CLAIR VASCULAR ASSOCIATES PC |
| NPI Number: | 1720167307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE M HALL (OFFICE ADMINISTRATOR) |
| Mailing Address: | 23829 Little Mack Suite 200 St. Clair Shores |
| State: | MI US |
| Postal Code: | 480801113 |
| Phone Number: | 5867724444 |
| Fax Number: | 5867724411 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 11/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |