Healthcare Provider Details

I. General information

NPI: 1770080624
Provider Name (Legal Business Name): MARCEL FRANCOIS EADIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

IV. Provider business mailing address

27451 CRANBROOK DR
FARMINGTON HILLS MI
48336-2230
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD210002607
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: