Healthcare Provider Details

I. General information

NPI: 1225102734
Provider Name (Legal Business Name): EARLEXIA M. NORWOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRY FORD HEALTH SYSTEM 2825 LIVERNOIS
TROY MI
48083
US

IV. Provider business mailing address

HENRY FORD HEALTH SYSTEM 2825 LIVERNOIS
TROY MI
48083
US

V. Phone/Fax

Practice location:
  • Phone: 248-680-6000
  • Fax: 248-680-6068
Mailing address:
  • Phone: 248-680-6000
  • Fax: 248-680-6068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301052833
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: