Organization
ST. CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC
Active
Organization
ST. CLAIR ORTHOPAEDICS AND SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANWALDEEP SIDHU MD (MD)
(586) 552-4571
Entity
Organization
Contact information
Practice address
23829 LITTLE MACK AVE STE 100, SAINT CLAIR SHORES, MI 48080-1186
(586) 773-1300
Mailing address
23829 LITTLE MACK AVE STE 100, SAINT CLAIR SHORES, MI 48080-1186
(586) 773-1300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E02122
BCBS PIN
MI
01
—
0E05556
BCBS DME PIN
MI
Enumeration date
09/19/2017
Last updated
07/21/2022
Update your record
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