MEDICARE: EVOLUTION CHIROPRACTIC HEALTH AND SPORT FITNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1366397754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVOLUTION CHIROPRACTIC HEALTH AND SPORT FITNESS

Provider Business Mailing Address
First Line	:	2041 E SQUARE LAKE RD STE 500
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-7800
Country	:	US
Telephone Number	:	248-636-3141
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 E SQUARE LAKE RD STE 500
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-7800
Country	:	US
Telephone Number	:	248-636-3141
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. JAWAD ALAM
Credential	:	D.C.
Telephone Number	:	248-416-8614

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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