Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Shelbydale Medical Clinic, P.C.

Family Medicine Physician in Shelby Twp, MI · enumerated 2007 · authorized official Keith Tom, President.

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

National Provider Identifier

1629258488

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Shelbydale Medical Clinic, P.C.

Practice address 49221 Van Dyke Ave, Shelby Twp, MI, 48317

Phone (586) 254-4860

Fax (586) 254-5844

Enumeration date Nov 9, 2007

Last updated in NPPES Nov 9, 2007

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License KT008999 (MI) Primary

Authorized official

Name Keith Tom

Title President

Phone (586) 254-4860

Other identifiers

Identifier	Type	State	Issuer
2646558	Medicaid	MI	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Shelbydale Medical Clinic, P.C. located?

The practice location on file with NPPES is in Shelby Twp, MI.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2007-11-09. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-11-09.