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

Dr. Kimberly Rose Coughlin, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1356791636

Dr. Kimberly Rose Coughlin, MD is a General Surgery in Saint Clair Shores, Michigan. Graduated from Wayne State University School of Medicine in 2016, 10 years ago. Practices with Henry Ford Health St John Hospital, a 330-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan and New York.

Years since qualifying
10
Trained at
Wayne State University School of Medicine
Licensed in
MI, NY
In the registry since
2016
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

29000 Little Mack Ave Ste B
Saint Clair Shores, MI 48081-3018
Phone: (586) 774-8811
Fax: (586) 541-0199
Show map & directions

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

Additional practice locations (2)

  • 22101 Moross Rd, Detroit, MI 48236-2148 — (313) 343-3878
  • 161 Fort Washington Ave Fl 8, New York, NY 10032-3729 — (212) 305-0519

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 4301506652 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 4301109635 (MI)
Surgery Physician Taxonomy 208600000X · Licence 309316 (NY)

Record details

NPI number1356791636
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 16, 2016
Last updated in NPPESJune 21, 2022
Certification dateJune 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Henry Ford Health St. John Hospital — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Saint Clair Shores