Healthcare Provider Details

I. General information

NPI: 1306755848
Provider Name (Legal Business Name): EDGE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 26 MILE RD STE 110
WASHINGTON MI
48094-3851
US

IV. Provider business mailing address

67222 GREYSTONE CT
WASHINGTON MI
48095-8000
US

V. Phone/Fax

Practice location:
  • Phone: 586-371-5556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA TUCZYNSKI
Title or Position: OWNER
Credential: MD
Phone: 586-371-5556