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General NPI Number Information
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NPI Number | 1306755848
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Entity Type | Organization
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Legal Business Name | EDGE HEALTH
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 6303 26 MILE RD STE 110
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City | WASHINGTON
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State | MI
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Zip | 48094-3851
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Country | US
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Telephone | 586-371-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 67222 GREYSTONE CT
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City | WASHINGTON
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State | MI
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Zip | 48095-8000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA TUCZYNSKI
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Credential | MD
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Telephone | 586-371-5556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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