# ST CLAIR SHORES OBSTETRICS AND GYNECOLGY, PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shores OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164535886
- **Authorized official:** DR. CONSTANTINE RAPHTIS D.O. (MEMBER)
- **Authorized official phone:** (586) 779-9400

## Contact information

- **Practice address:** 19714 E 10 MILE RD, SAINT CLAIR SHORES, MI 48080-1064
- **Practice address phone:** (586) 779-9400
- **Practice address fax:** (586) 779-8949
- **Mailing address:** 19714 TEN MILE ROAD, ST CLAIR SHORES, MI 48080
- **Mailing address phone:** (586) 779-9400
- **Mailing address fax:** (586) 779-8949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 08/22/2020