# SOUTHEASTERN MICHIGAN MEDICAL CONSULTANTS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942300884
- **Authorized official:** DR. RUDY JEROME VERVAEKE MD (CEO)
- **Authorized official phone:** (586) 775-7400

## Contact information

- **Practice address:** 21420 HARPER AVE, SUITE 2, SAINT CLAIR SHORES, MI 48080-3607
- **Practice address phone:** (586) 775-7400
- **Practice address fax:** (586) 775-0091
- **Mailing address:** 21420 HARPER AVE, SUITE 2, SAINT CLAIR SHORES, MI 48080-3607
- **Mailing address phone:** (586) 775-7400
- **Mailing address fax:** (586) 775-0091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 4301044898 | MI | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 02/06/2015