Provider Demographics
NPI:1255105045
Name:SUNSHINE FAMILY CARE CLINIC, PLLC
Entity type:Organization
Organization Name:SUNSHINE FAMILY CARE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEYDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SU HAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-620-0250
Mailing Address - Street 1:G3169 BEECHER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3611
Mailing Address - Country:US
Mailing Address - Phone:810-620-0250
Mailing Address - Fax:810-620-0255
Practice Address - Street 1:G3169 BEECHER RD STE 100
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3611
Practice Address - Country:US
Practice Address - Phone:810-620-0250
Practice Address - Fax:810-620-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty