Healthcare Provider Details

I. General information

NPI: 1609568773
Provider Name (Legal Business Name): ANDREW HAE-MIN EO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 09/20/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ASCENSION-MACOMB OAKLAND HOSPITAL 11800 E. 12 MILE ROAD
WARREN MI
48093
US

IV. Provider business mailing address

ASCENSION-MACOMB OAKLAND HOSPITAL 11800 E. 12 MILE ROAD
WARREN MI
48093
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-5059
  • Fax: 586-573-5855
Mailing address:
  • Phone: 586-573-5059
  • Fax: 586-573-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: