Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shelbydale Medical Clinic, PC

Organization Family Medicine Physician · NPI 1629258488

Shelbydale Medical Clinic, PC is a Family Medicine Physician in Shelby Twp, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

49221 Van Dyke Ave
Shelby Twp, MI 48317-1336
Phone: (586) 254-4860
Fax: (586) 254-5844
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence KT008999 (MI)

Record details

NPI number1629258488
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keith Tom — President · (586) 254-4860
NPI enumeratedNovember 9, 2007
Last updated in NPPESNovember 9, 2007
Mailing address49221 Van Dyke Ave, Shelby Twp, MI 48317-1336

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