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1063719292
ST CLAIR SPECIALTY PHYSICIANS
BOISE, ID
NPI
1063719292
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Entity Type
Organization
Authorized Contact
ROBERT PROVENZANO
President/Partner
313-886-8787
Organization Subpart ?
No
Primary Taxonomy
207RN0300X Internal Medicine, Nephrology
Enumeration Date
2011-02-24
Last Update Date
2011-02-24
Business Address
ST CLAIR SPECIALTY PHYSICIANS
5610 GAGE STREET SUITE A
BOISE, ID 83706
Phone number: 208-367-3370
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Mailing Address
ST CLAIR SPECIALTY PHYSICIANS
45640 SCHOENHERR ROAD
SHELBY TWP, MI 48315
Phone number: 586-247-4300
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