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

St Clair Specialty Physicians PC

Organization Nephrology Physician · NPI 1154361616

St Clair Specialty Physicians PC is a Nephrology Physician in Roseville, Michigan. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
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

18001 E 10 Mile Rd Ste 1
Roseville, MI 48066-3803
Phone: (586) 218-5800
Fax: (586) 532-6496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X
Vascular Surgery Physician Taxonomy 2086S0129X

Record details

NPI number1154361616
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Provenzano — Ceo/Managing Employee (W2) · (586) 286-7800
Other names St. Clair Nephrology, Idaho Nephrology Associates; St. Clair Nephrology, Idaho Nephrology Associates
NPI enumeratedJune 6, 2006
Last updated in NPPESOctober 17, 2022
Certification dateOctober 17, 2022
Mailing address45640 Schoenherr Rd, Shelby Township, MI 48315-6033

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