Provider Demographics
NPI:1811007479
Name:SAUNDERS, STANLEY KEEMER (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:KEEMER
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22255 GREENFIELD RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3700
Mailing Address - Country:US
Mailing Address - Phone:248-849-8350
Mailing Address - Fax:
Practice Address - Street 1:22255 GREENFIELD RD STE 130
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3700
Practice Address - Country:US
Practice Address - Phone:248-849-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI036560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1045051290 TYPE 10Medicaid
MI1045051290 TYPE 10Medicaid
MIE26779Medicare UPIN