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NPI Code Detail

MEDICARE: MICHAEL J EADIE MD

MEDICARE: MICHAEL J EADIE MD
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
1207RA0401XAddiction Medicine (Internal Medicine) Physician4301044474MI

General Provider Information

NPI Number : 1538106026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J EADIE MD
Provider Business Mailing Address
First Line : 400 STODDARD RD
Second Line :
City : RICHMOND
State : MI
Zip : 48062-2505
Country : US
Telephone Number : 810-392-2167
Fax Number : 810-392-2057
Provider Business Practice Location Address
First Line : 400 STODDARD RD
Second Line :
City : RICHMOND
State : MI
Zip : 48062-2505
Country : US
Telephone Number : 810-392-2167
Fax Number : 810-392-2057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 12/24/2008

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