Provider Demographics
NPI:1831714088
Name:SAUERBECK, TYLER JORDAN (DO)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JORDAN
Last Name:SAUERBECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29000 LITTLE MACK AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3018
Mailing Address - Country:US
Mailing Address - Phone:586-343-8717
Mailing Address - Fax:586-343-8773
Practice Address - Street 1:29000 LITTLE MACK AVE STE A
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3018
Practice Address - Country:US
Practice Address - Phone:586-343-8717
Practice Address - Fax:586-343-8773
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151015959208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty