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General NPI Number Information
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NPI Number | 1770815771
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Entity Type | Organization
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Legal Business Name | MICHAEL H. EIDELMAN M.D. P.C.
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 30335 W 13 MILE RD SUITE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2262
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Country | US
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Telephone | 248-626-6500
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Fax | 248-855-0190
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Provider Business Mailing Address
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Address Line | 30335 W 13 MILE RD SUITE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2262
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Country | US
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Telephone | 248-626-6500
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Fax | 248-855-0190
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL HUGH EIDELMAN
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Credential | M.D.
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Telephone | 248-626-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301031934
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License Number State | MI
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