Healthcare Provider Details

I. General information

NPI: 1336711712
Provider Name (Legal Business Name): ALEC MERLINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST # 5C
DETROIT MI
48201-2153
US

IV. Provider business mailing address

4201 SAINT ANTOINE ST # 5C
DETROIT MI
48201-2153
US

V. Phone/Fax

Practice location:
  • Phone: 313-577-5092
  • Fax: 313-745-4707
Mailing address:
  • Phone: 313-577-5092
  • Fax: 313-745-4707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301518057
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: