Individual
SARAH BETHANY MCDADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27209 LAHSER RD, SUITE 221, SOUTHFIELD, MI 48034-8401
(248) 569-2000
(248) 569-2008
Mailing address
1405 BALMORAL DR, DETROIT, MI 48203-1442
(313) 622-5662
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4301074905
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0636250
BCBSM PIN
MI
01
—
0P50670
MEDICARE GROUP NUMBER
MI
01
—
134931
CARE CHOICES
MI
01
—
157928
GREAT LAKES HEALTH PLAN
MI
05
—
1760455513
—
MI
01
—
1951791
UNITED HEALTHCARE
MI
01
—
421720541
TRICARE STANDARD
MI
05
—
4818400-10
—
MI
05
—
4925830
—
MI
05
—
4933804
—
MI
05
—
4933813
—
MI
01
—
612901000
DOL / WORKERS COMP
MI
01
—
7526086
AETNA
MI
Enumeration date
02/10/2006
Last updated
03/19/2021
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