Healthcare Provider Details

I. General information

NPI: 1518932847
Provider Name (Legal Business Name): EDWARD ALPERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 E 12 MILE RD SUITE 100
WARREN MI
48093-3400
US

IV. Provider business mailing address

49 S CASS ST SUITE 1B
BATTLE CREEK MI
49017-2331
US

V. Phone/Fax

Practice location:
  • Phone: 586-751-1122
  • Fax: 586-751-5119
Mailing address:
  • Phone: 269-969-8920
  • Fax: 269-969-8921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number4301027263
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: