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Southeastern Michigan Kidney Center Pllc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Berkley, MI · enumerated 2006 · authorized official David Shepherd, Vice President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1316967797

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Registry record

Entity type Organization (Type 2)
Legal business name Southeastern Michigan Kidney Center Pllc
Practice address 1695 W 12 Mile Rd, Suite 250, Berkley, MI, 48072
Fax (248) 414-5227
Enumeration date Jul 20, 2006
Last updated in NPPES Sep 28, 2011

Taxonomy & classification

261QE0700X End-Stage Renal Disease (ESRD) Treatment Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name David Shepherd
Title Vice President

Other identifiers

Identifier Type State Issuer
000000009371 Other - CAPE
08981 Other - BLUE CROSS PRIMARY
08981 Other - FED BLUE CROSS PRIMARY
1022510001 Other - WELLNESS
140042 Other - CARE CHOICES
OP630345 Other - M CARE
09499 Other - BLUE CROSS SECONDARY
501076 Other - ULTI MED
567595 Other - SELECTCARE
P117519 Other - BLUE CARE NETWORK
140042 Other - PREFERRED CHOICE
09499 Other - FED BLUE CROSS SECONDARY
8203 Other - GREATLAKES
232574 Other - HAP
4112097 Medicaid MI -

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2011-09-28. Verify at npiregistry.cms.hhs.gov.
Where is Southeastern Michigan Kidney Center Pllc located?
The practice location on file with NPPES is in Berkley, MI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-09-28.